engAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105431055530299Lifestyle Components and Primary Breast Cancer PreventionBreast cancer primary prevention is a high research priority due to the high psychological and economic costs.The disease is a multistep process and several risk factors have been recognized. Over the past three decadesnumerous studies have investigated the association of lifestyle with breast cancer, showing independent effects ofvarious factors. We report here a summary of the present state of knowledge on the role of lifestyle patterns, suchas physical activity, diet, smoking, hormone therapy, and experience of psychological stress in the modulation ofbreast cancer in women, and discuss commonly accepted biological mechanisms hypothesized as responsible forthe associations. The findings indicate that regular physical activity of moderate to vigorous intensity is probablylinked with the decreased breast cancer risk among postmenopausal females and suggestive for a decrease of therisk in premenopausal women. In contrast, the consumption of high-fat diet, alcohol intake, and use of combinedestrogen and synthetic progestagen hormonal therapy may increase the risk. Epidemiological findings dealingwith a role of smoking and experience of psychological stress are conflicting.http://journal.waocp.org/article_30299_6c5116023ff04d47724a04b10feecee2.pdfBreast cancerlifestyle factorsreviewengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105571056330300Autophagy-associated Targeting Pathways of Natural Products during Cancer TreatmentIt is well known that conventional chemotherapy and radiation therapy can result in toxicity to both normalcells and tumor cells, which causes limitations in the application of these therapeutic strategies for cancer control.Novel and effective therapeutic strategies for cancers with no or low toxicity for normal cells are a high priority.Therefore, natural products with anticancer activity have gained more and more attention due to their favorablesafety and efficacy profiles. Pre-clinical and clinical studies have demonstrated that several representative naturalcompounds such as resveratrol, epigallocatechin-3-gallate, curcumin, allicin and ginsenosides have obviousanticancer potential. In this article, we summarize autophagy-associated targeting pathways of such naturalproducts for inducing the death of cancer cells, and discuss the core autophagic pathways involved in cancertreatments. Recent advances in the discovery, evaluation and exploitation of natural compounds as therapeuticagents for cancers will provide references and support in pre-clinical and clinical application of novel naturaldrugs for the treatment of primary and metastatic tumors in the future.http://journal.waocp.org/article_30300_04053e65b2b43328ef18469ad9cadceb.pdfautophagyResveratrolEpigallocatechin-3-gallateCurcuminallicinginsenosideengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105651057130301Gastric Cancer in Asian American Populations: a Neglected Health DisparityGastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. TheAsian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent.A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and SoutheastAsian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the USis over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trialshave provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventinggastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancermortality following the implementation of programs to detect early stage gastric cancers. There are currently noclear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrantpopulations. However, it is likely that a proportion of US physicians are already recommending gastric cancerscreening for Asian patients and some Asian immigrants to the US may be completing screening for gastriccancer in their native countries. Surveys of US primary care physicians and Asian American communities shouldbe conducted to assess current provider practices and patient uptake with respect to gastric cancer preventionand control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groupscould consider a shared decision-making approach to helicobacter pylori identification and eradication, as wellas gastric endoscopy.http://journal.waocp.org/article_30301_5dc961831195247386c2245f085f7337.pdfAsian AmericansGastric cancerhealth disparityprimary preventionsecondary preventionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105731057630302A Novel Model for Smart Breast Cancer Detection in Thermogram ImagesBackground: Accuracy in feature extraction is an important factor in image classification and retrieval. In thispaper, a breast tissue density classification and image retrieval model is introduced for breast cancer detectionbased on thermographic images. The new method of thermographic image analysis for automated detection ofhigh tumor risk areas, based on two-directional two-dimensional principal component analysis technique forfeature extraction, and a support vector machine for thermographic image retrievalwas tested on 400 images.The sensitivity and specificity of the model are 100% and 98%, respectively.http://journal.waocp.org/article_30302_8d52e8fcf27f68ee3b0845288d685a8a.pdfThermographic imagehot areaSupport Vector MachineFeature extractionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105771058330303Clinicopathological Characteristics of Triple Negative Breast Cancer at a Tertiary Care Hospital in IndiaBackground: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogenreceptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with apoor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling andmost authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotypedespite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study wasaimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCsand categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between twosubtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC casesduring January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study weredifferentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers34βE12, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects werecollated from clinical records. The comparison of clinicopathological features between two subgroups was doneusing statistical analyses. The pattern of treatment failure along with its association with prognostic factorswas assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBLsubtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant associationwas seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% werewith BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively.Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Diseasestage at presentation is an important prognostic factor influencing the treatment failure and survival amongTNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinicalcourse than that of NBL as shown by shorter DFS and OS, despite having no statistically significant differencebetween prognostic parameters. New therapeutic alternatives should be explored for patients with this subtypeof breast cancer.http://journal.waocp.org/article_30303_724ca5689de8c0991b5302fda65017bc.pdfTriple-negative breast cancerbasal-likenon-basal-likeprognosisIndiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105851058930304Clinicopathological Significance of BRCA1 Promoter Hypermethylation in Thai Breast Cancer PatientsBreast cancer susceptibility gene 1 (BRCA1), mapped on chromosome 17q21, is implicated in the mechanismsof cellular DNA repair. Inactivation of this gene is involved in the development of many human cancers, includingbreast cancer. This study aimed to investigate the prognostic value of BRCA1 promoter hypermethylation andexpression in breast cancer cases. Sixty-one breast cancers were examined for BRCA1 hypermethylation bymethylation-specific polymerase chain reaction (PCR), and 45 paired normal breast tissues were analyzed foraltered BRCA1 mRNA levels by quantitative real-time reverse transcription-polymerase chain reaction (qRTPCR).Aberrant methylation status in BRCA1 was detected in 15 of 61 cases (24.6%), while reduced expressionwas found in 7 of 45 (15.6%). BRCA1 hypermethylation was statistically associated with tumor grade III (p=0.04),a high frequency of stage IIB (p=0.02), and triple-negative phenotype (OR= 3.64, 95%CI =1.1-12.3, p=0.03). Ourfindings indicated that BRCA1 promoter hypermethylation is a useful prognostic marker for breast cancer.http://journal.waocp.org/article_30304_114969e23509677fe1248c4adb16a0ba.pdfBreast cancerBRCA1DNA methylationmethylation-specific PCRGene expressionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105911059630305Expression of Tumor Necrosis Factor Receptor-associated Factor 6 in Lung Cancer TissuesBackground: Tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6) has been reported to beassociated with the development of various cancers. However, the role of TRAF6 in lung cancer remains unclear.Objective: To explore the expression and clinicopathological significance of TRAF6 protein in lung cancer tissues.Materials and Methods: Three hundred and sixty-five lung cancer samples and thirty normal lung tissues wereconstructed into 3 microarrays. The expression of TRAF6 protein was determined using immunohistochemistry(IHC). Furthermore, correlations between the expression of TRAF6 and clinicopathological parameters wereinvestigated. Results: The expression of TRAF6 in total lung cancer tissues (365 cases), as well as in small celllung cancer (SCLC, 26 cases) and non-small cell lung cancer (NSCLC, 339 cases) was significantly highercompared with that in normal lung tissues. The ROC curve showed that the area under curve of TRAF6 was0.663 (95%CI 0.570~0.756) for lung cancer. The diagnostic sensitivity and specificity of TRAF6 were 52.6% and80%, respectively. In addition, the expression of TRAF6 was correlated with clinical TNM stage, tumor size andlymph node metastasis in all lung cancers. Consistent correlations were also observed for NSCLCs. Conclusions:TRAF6 might be an oncogene and the expression of TRAF6 protein is related to the progression of lung cancer.Thus, TRAF6 might become a target for diagnosis and gene therapy for lung cancer patients.http://journal.waocp.org/article_30305_4ea401ed6dcfb61b104562a4714c6b84.pdfTNF receptor-associated factor 6Lung cancerImmunohistochemistryTNM stageengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524105971060130307RNAi-based Knockdown of Multidrug Resistance-associated Protein 1 is Sufficient to Reverse Multidrug Resistance of Human Lung CellsUp-regulation of multidrug resistance-associated protein 1 (MRP1) is regarded as one of the main causes formultidrug resistance (MDR) of tumor cells, leading to failure of chemotherapy-based treatment for a multitude ofcancers. However, whether silencing the overexpressed MRP1 is sufficient to reverse MDR has yet to be validated.This study demonstrated that RNAi-based knockdown of MRP1 reversed the increased efflux ability and MDRefficiently. Two different short haipin RNAs (shRNAs) targeting MRP1 were designed and inserted into pSilence-2.1-neo. The shRNA recombinant plasmids were transfected into cis-dichlorodiamineplatinum-resistant A549lung (A549/DDP) cells, and then shRNA expressing cell clones were collected and maintained. Real time PCRand immunofluorescence staining for MRP1 revealed a high silent efficiency of these two shRNAs. Functionally,shRNA-expressing cells showed increased rhodamine 123 retention in A549/DDP cells, indicating reduced effluxability of tumor cells in the absence of MRP1. Consistently, MRP1-silent cells exhibited decreased resistance to3- (4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and DDP, suggesting reversal of MDRin these tumor cells. Specifically, MRP1 knockdown increased the DDP-induced apoptosis of A549/DDP cellsby increased trapping of their cell cycling in the G2 stage. Taken together, this study demonstrated that RNAibasedsilencing of MRP1 is sufficient to reverse MDR in tumor cells, shedding light on possible novel clinicaltreatment of cancers.http://journal.waocp.org/article_30307_d5596e13448434f54ddc038dedacd4a5.pdfMultidrug ResistanceMRP1shRNAProtein expressiontumor cellsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106031060530309Evaluation of Environmental Risk Factors for Prostate Cancer in a Population of Iranian PatientsBackground: The Prostate cancer is the 2nd most common cancer worldwide for males, and the 5th mostcommon cancer overall, with an estimated 900,000 new cases diagnosed in 2008 (14% of the total in males and 7%of the total overall) aim of this study was to assess some of the most proposed environmental factors influencingthe incidence of prostate cancer among Iranian men. Smoking, opioids, occupation and living location wereconsidered as studied risk factors of the prostate cancer in this research. Material and methods: Two groupsof affected men with prostate cancer and controls aged 50-75 years referred to medical clinics were subjectsin this case-control study. Living and working place, smoking and drug consuming habits were assessed forany associations with prostate cancer. Results: The largest number, of patients, in order, belonged to Tehran,provincial capitals, major industrial cities, small towns and villages, respectively. The disease showed links withsmoking and drugs with a significant difference between controls and patients (P value http://journal.waocp.org/article_30309_a2c6c5fab3c2c343bd11630f4bab4588.pdfengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106071061130310Is Her-2 Status in the Primary Tumor Correlated with Matched Lymph Node Metastases in Patients with Gastric Cancer Undergoing Curative Gastrectomy?Background: HER2 expression in the primary tumor and its lymph node metastases vary in gastric cancer,reflecting intratumoral heterogeneity. This finding also suggests that proliferation of a different clone in metastaticnodes is possible. In the current study, we aimed to determine the cause of discordance in HER-2 expressionin the primary tumor and lymph node metastases for patients with gastric cancer. Materials and Methods:Eighty-one patients with gastric cancer who had undergone radical gastrectomy and were found to have lymphnode metastasis upon pathological examination were included. Histopathological samples were obtained frombiopsies obtained during patient gastrectomies and lymph node dissection. HER2 status was evaluated by bothimmunohistochemistry (IHC) and silver in situ hybridization (SISH). Results: Sixty-four (79%) patients wereSISH (-), while 17 (21%) were SISH (+) in the primary tumor. However, in metastatic lymph nodes, HER2 statuswas SISH positive in 5 (28.3%) of the 64 SISH (-) primary tumor specimens. One of the 17 SISH (+) primarytumors was SISH (-) in the metastatic lymph nodes. Thus, SISH results for HER2 in both primary tumors andlymph node metastases were comparable, showing a concordance of 92.5%. In total, six patients demonstrateddiscordance between the primary tumor and lymph node metastases. The prevalence of HER2 discordance wassignificantly higher for patients in the pN2 and N3 stages (p=0.007). Although discordant patients had worsesurvival rates than concordant patients, the differences were not significant (p>0.05).Conclusions: Our studyindicates that the frequency of concordance in HER2 status, as determined by IHC or SISH, is high in primarytumors and their corresponding lymph node metastases for patients with gastric cancer. If there is a discrepancyin HER2 status, its evaluation by both IHC and SISH may be useful for detecting patients who would benefitfrom trastuzumab, and it would therefore help guide decision-making processes in administering treatment.http://journal.waocp.org/article_30310_59576bec70dbd8bd980f1ce0378cbc73.pdfImmunohistochemistryHER2silver in situ hybridizationGastric cancerTrastuzumabengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106131061930311Ethanol but not Aqueous Extracts of Tubers of Sauromatum Giganteum(Engl.) Cusimano and Hett Inhibit Cancer Cell ProliferationBackground: Both alcohol and aqueous extracts of Sauromatum giganteum(Engl.) Cusimano and Hett, the driedroot tuber of which is named Baifuzi in Chinese, have been used for folklore treatment of cancer in Northeastof China. However, little is known about which is most suitable to the cancer therapy. Materials and Methods:Serum pharmacology and MTT assays were adopted to detect the effects of ethanol and aqueous extracts ofSauromatum giganteum(Engl.) Cusimano and Hett , prepared by heat reflux methods, on proliferation of differentcancer cells. Results: Cancer cells treated with medium supplemented with 10%, 20%, 40% serum(v/v) containingethanol extract had a decline in viability, with inhibition rates of 7.69%, 21.8%, 41.9% in MCF-7 cells, 42.8%,48.1%, 51.8% in SGC-7901 cells, 44.1%, 49.2%, 53.7% in SMMC-7721 cells, 6.8%, 15.2%, 39.8% in HepG2cells, 7.57%, 16.3%, 36.2% in HeLa cells, 6.24%, 12.5%, 27.4% in A549 cells, and 7.20%, 17.5%, 31.3% inMDA-MB-231 cells, respectively. Viability in the aqueous extract groups was no different with that of controls.Conclusions: An ethanol extract of Sauromatum giganteum(Engl.) Cusimano and Hett inhibited the proliferationof SMMC-7721, SGC-7901 and MCF-7 cells, which supports the use of alcoholic but not aqueous extracts forcontrol of sensive cancers, which might include hepatocarcinoma, gastric cancer and breast cancer.http://journal.waocp.org/article_30311_1e36697ee4692ced0938aa6073b29ab1.pdfSauromatum giganteumethanol extractInhibitionaqueous extarctsserum pharmacologycancerengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106211062530312High Expression of Forkhead Box Protein C2 is Related to Poor Prognosis in Human GliomasBackground: Increasing evidence has indicated that high Forkhead box protein C2 (FOXC2) level is closelyassociated with the development, progression, and poor prognosis of a variety of tumors. However, the relationshipbetween FOXC2 and the progression of human gliomas remains to be clarified. The aim of present study was toassess FOXC2 expression and to explore its contribution in human gliomas. Materials and Methods: Realtimequantitative PCR was performed to examine FOXC2 expression in 85 pairs of fresh frozen glioma tissues andcorresponding non-neoplastic brain tissues. Associations of FOXC2 expression with clinicopathological factorsand prognosis of glioma patients were statistically analyzed. Results: The relative mRNA expression of FOXC2was significantly higher in glioma tissues than the corresponding non-neoplastic brain tissues (phttp://journal.waocp.org/article_30312_f35142b901e0033452a3c9c1cb560eb8.pdfHuman gliomaforkhead box protein C2prognosisengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106271063030313Epidermal Growth Factor Receptor Mutations in Japanese Men with Lung AdenocarcinomasBackground: Epidermal growth factor receptor (EGFR) mutations play a vital role in the prognosis of patientswith lung adenocarcinoma. Such somatic mutations are more common in women who are non-smokers withadenocarcinoma and are of Asian origin. However, to our knowledge, there are few studies that have focusedon men. Materials and Methods: One hundred and eighty-four consecutive patients (90 men and 94 women) ofresected lung adenocarcinoma were studied retrospectively. Results: EGFR mutations were positive in 48.9%and negative (wild type) in 51.1%. Overall mutation was significant in women (66.0% vs. 32.2%) compared withmen (phttp://journal.waocp.org/article_30313_71e6f94b86d034db92d8084926edeb74.pdfEGFR mutationMenLung adenocarcinomaBrinkman indexengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106311063630315Depression, Anxiety and Sexual Satisfaction in Breast Cancer Patients and their Partners-Izmir Oncology Group StudyBackground: We aimed to investigate anxiety, depression and sexual satisfaction levels and the effects ofdepression and anxiety upon the sexual satisfaction of Turkish breast cancer patients and their partners. Materialsand Methods: Data were collected from one hundred breast cancer patients and their partners, using threeforms: one covering information about socio-demographic characteristics of the patients, the Hospital Anxietyand Depression Scale (HADs) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Results: Thefrequencies, avoidance and touch subscores were statistically significantly high in the patients. Among thosewith high anxiety scores, the frequency, communication, satisfaction, touch, and anorgasmic subscale scoresof GRISS were found to be significantly high. Among the partners whose anxiety scores were high, only thepremature ejaculation subscale was statistically significant. It was determined that for partners with higherdepression scores, the communication, satisfaction, avoidance, premature ejaculation and erectile dysfunctionsubscores of GRISS were statistically higher compared to partners with lower depression scores. Conclusions:Patients’ quality of life may be increased by taking precautions to reduce their and their partners’ psychosocialand psychosexual concerns.http://journal.waocp.org/article_30315_9bb7708f12432824d62d2cd8ab78f24d.pdfDepressionAnxietysexual satisfactionBreast cancerTurkeyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106371064230317How Compliant are Tobacco Vendors to India’s Tobacco Control Legislation on Ban of Advertisments at Point of Sale? A Three Jurisdictions ReviewBackground: Section 5 of India’s tobacco control legislation “Cigarettes and Other Tobacco Products Act(COTPA), 2003”comprehensively prohibits all kinds of tobacco advertisement, promotion and sponsorship(TAPS), but permits advertisments at the point-of-sale (POS) under certain conditions. This provision hasbeen exploited by the tobacco companies to promote their products. Objective: To measure compliance withthe provisions of Section 5 of Indian tobacco control legislation (COTPA, 2003) at point of sale. Materials andMethods: A cross-sectional survey using an observation checklist was conducted in 1860 POS across threejurisdictions (Chennai city, District Vadodara and District Mohali) in India. Results: The most common modeof advertisement of tobacco products was product showcasing (51.1%), followed by dangles (49.6%), stickers(33.8%) and boards (27.1%). More than one fourth of POS were found violating legal provisions for displayingadvertisement boards in one or other forms (oversized, extended to full body lenth of POS, displayed brandname/packshot and promotional messages). Advertisement boards (16.3%) without health warnings were also foundand wherever found, more than 90% health warning were not as per the specification in respect to size, font andbackground color. Conclusions: Point of sale advertising is aggressively used by the tobacco industry to promotetheir products. There is an urgent need of effective implementation of a comprehensive ban on tobacco productadvertisement, promotion and sponsorship at point of sale.http://journal.waocp.org/article_30317_6884eb8a3abc2cdc31052eecd3c31dd4.pdfCompliance assessmentTobaccoAdvertisingCOTPATAPSpoint of saleIndiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106431064630320Correlation Between Mammograghic Findings and Clinical/Pathologic Features in Women with Small Invasive Breast CarcinomasBackground: To study the relationship between mammographic findings and clinical/pathologic features inwomen with 1-15mm sized invasive breast cancer. Materials and Methods: We investigated a consecutive seriesof 134 cases diagnosed in Tianjin Medical University Cancer Institute and Hospital in 2007. Mammographicfindings were classified into five groups as follows :1) stellate mass without calcification; 2) non-stellate masswithout calcification; 3) intermediate suspicious calcification with or without associated mass; 4) higher probabilitymalignant calcification with or without associated mass; 5) focal asymmetry/distortion without associatedcalcification. Associations between mammographic and clinical/pathological features (menopause status/familyhistory/histologic grade/lymph node status and ER/PR/HER2 status) was analyzed through logistic regressionand chi square tests. Results: Compared to the stellate mass without calcification group, higher probabilitymalignant calcification patients were associated significantly with a positive lymph node status, always presentingin patients who were non-menopausal and with a family history of carcinoma. Conclusions: Higher probabilitymalignant calcifications with or without associated tumor masses are associated with clinical/pathologic featuresof poor prognosis.http://journal.waocp.org/article_30320_98908a025c9c2958f135742abd966bf8.pdfmammography findingsbreast carcinomaclinical/pathologic featurescalcificationengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106471065230322Co-amplification at Lower Denaturation-temperature PCR Combined with Unlabled-probe High-resolution Melting to Detect KRAS Codon 12 and 13 Mutations in Plasma-circulating DNA of Pancreatic Adenocarcinoma CasesBackground: The aim of our study was to establish COLD-PCR combined with an unlabeled-probe HRMapproach for detecting KRAS codon 12 and 13 mutations in plasma-circulating DNA of pancreatic adenocarcinoma(PA) cases as a novel and effective diagnostic technique. Materials and Methods: We tested the sensitivity andspecificity of this approach with dilutions of known mutated cell lines. We screened 36 plasma-circulating DNAsamples, 24 from the disease control group and 25 of a healthy group, to be subsequently sequenced to confirmmutations. Simultaneously, we tested the specimens using conventional PCR followed by HRM and then usedtarget-DNA cloning and sequencing for verification. The ROC and respective AUC were calculated for KRASmutations and/or serum CA 19-9. Results: It was found that the sensitivity of Sanger reached 0.5% with COLDPCR,whereas that obtained after conventional PCR did 20%; that of COLD-PCR based on unlabeled-probeHRM, 0.1%. KRAS mutations were identified in 26 of 36 PA cases (72.2%), while none were detected in thedisease control and/or healthy group. KRAS mutations were identified both in 26 PA tissues and plasma samples.The AUC of COLD-PCR based unlabeled probe HRM turned out to be 0.861, which when combined with CA19-9 increased to 0.934. Conclusions: It was concluded that COLD-PCR with unlabeled-probe HRM can be asensitive and accurate screening technique to detect KRAS codon 12 and 13 mutations in plasma-circulatingDNA for diagnosing and treating PA.http://journal.waocp.org/article_30322_233a92d5c8cf4faeb88248a698134f70.pdfPlasma-circulating DNApanreatic adenocarcinomaKRAS geneunlabled-probehigh-resolution meltingmutationsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106531065830324Association of a p53 Codon 72 Gene Polymorphism with Environmental Factors and Risk of Lung Cancer: a Case Control Study in Mizoram and Manipur, a High Incidence Region in North East IndiaBackground: A very high incidence of lung cancer is observed in Mizoram and Manipur, North East India.We conducted a population based case control study to establish associations of p53 codon 72 polymorphisms andinteractions with environmental factors for this high incidence. Material and Methods: A total of 272 lung cancercases and 544 controls matched for age (±5 years), sex and ethnicity were collected and p53 codon 72 polymorphismgenotypes were analyzed using a polymerase chain based restriction fragment length polymorphism assay. Weused conditional multiple logistic regression analysis to calculate adjusted odds ratios and 95% confidenceintervals after adjusting for confounding factors. Results: p53 Pro/Pro genotype was significantly associated withincreased risk of lung cancer in the study population (adjusted OR=2.14, CI=1.35-3.38, p=0.001). Interactionsof the p53 Pro/Pro genotype with exposure to wood smoke (adjusted OR=3.60, CI=1.85-6.98, phttp://journal.waocp.org/article_30324_d41d8cd98f00b204e9800998ecf8427e.pdfp53SNPLung cancergene-environment interactionsNorth-East IndiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106591066330326Effects of Rapamycin on Cell Apoptosis in MCF-7 Human Breast Cancer CellsBackground: Rapamycin is an effective anti-angiogenic drug. However, the mode of its action remainsunclear. Therefore, in this study, we aimed to elucidate the antitumor mechanism of rapamycin, hypotheticallyvia apoptotic promotion, using MCF-7 breast cancer cells. Materials and Methods: MCF-7 cells were platedat a density of 15105 cells/well in 6-well plates. After 24h, cells were treated with a series of concentrations ofrapamycin while only adding DMEM medium with PEG for the control regiment and grown at 37oC, 5% CO2and 95% air for 72h. Trypan blue was used to determine the cell viability and proliferation. Untreated andrapamycin-treated MCF-7 cells were also examined for morphological changes with an inverted-phase contrastmicroscope. Alteration in cell morphology was ascertained, along with a stage in the cell cycle and proliferation.In addition, cytotoxicity testing was performed using normal mouse breast mammary pads. Results: Our resultsclearly showed that rapamycin exhibited inhibitory activity on MCF-7 cell lines. The IC50 value of rapamycin onthe MCF-7 cells was determined as 0.4μg/ml (phttp://journal.waocp.org/article_30326_6c07989a7549fe88020ca1f860c84112.pdfRapamycinMCF-7 breast cancer cellsApoptosisengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106651067330328Performance Indices of Needle Biopsy Procedures for the Assessment of Screen Detected Abnormalities in Services Accredited by BreastScreen AustraliaBackground: We wished to analyse patterns of use of needle biopsy procedures by BreastScreen Australia(BSA) accredited programs to identify areas for improvement. Design: BSA services provided anonymous dataregarding percutaneous needle biopsy of screen detected lesions assessed between 2005-2009. Results: 12 services,from 5 of 7 Australian states and territories provided data for 18212 lesions biopsied. Preoperative diagnosis rateswere 96.84% for lesion other than microcalcification (LOTM) and 93.21% for microcalcifications. At surgery97.9% impalpable lesions were removed at the first procedure. Of 11548 Microcalcification (LOTM) biopsied,46.9% were malignant. The final diagnosis was reached by conventional core biopsy (CCB) in 72.46%, FNAB in21.33%, VACB in 1.69% and open biopsy in 4.52% of lesions. FNA is being limited to LOTM with benign imagingAfter FNAB, core biopsy was required for 38% of LOTM. In LOTM the mean false positive rate (FPR) was0.36% for FNAB, 0.06% for NCB and 0% for VACB. Diagnostic accuracy was 72.75% for FNAB and 92.1% forcore biopsies combined. Of 6441 microcalcifications biopsied 2305 (35.8%) were malignant. Microcalcificationsare being assessed primarily by NCB but 6.57% underwent FNAB, 45.6% of which required NCB. False positivediagnoses were rare. FNR was 5% for NCB and 1.53% for VACB. Diagnostic accuracy was 73.52% for FNAB,86.29% for NCB and 88.63% for VACB. Only 8 of 12 services had access to VACB facilities. Conclusions: BSAservices are selecting lesions effectively for biopsy and are achieving high preoperative diagnosis rates. Gaps inthe present accreditation standards require further consideration.http://journal.waocp.org/article_30328_c85719c85e12c3772aced3171f46a044.pdfBreast cancerScreeningMammographyneedle biopsyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106751068130330Meta-analysis of Associations between ATM Asp1853Asn and TP53 Arg72Pro Polymorphisms and Adverse Effects of Cancer RadiotherapyBackground: The ataxia telangiectasia mutated (ATM) protein and p53 play key roles in sensing and repairingradiation-induced DNA double strand breaks (DSBs). Accumulating epidemiological evidence indicates thatfunctional genetic variants in ATM and TP53 genes may have an impact on the risk of radiotherapy-induced sideeffects. Here we performed a meta-analysis to investigate the potential interaction between ATM Asp1853Asnand TP53 polymorphisms and risk of radiotherapy-induced adverse effects quantitatively. Materials andMethods: Relevant articles were retrieved from PubMed, ISI Web of Science and the China National KnowledgeInfrastructure (CNKI) databases. Eligible studies were selected according to specific inclusion and exclusioncriteria. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to estimate the association betweenATM Asp1853Asn and TP53 Arg72Pro polymorphisms and risk of radiotherapy adverse effects. All analyses wereperformed using the Stata software. Results: A total of twenty articles were included in the present analysis. Inthe overall analysis, no significant associations between ATM Asp1853Asn and TP53 Arg72Pro polymorphismsand the risk of radiotherapy adverse effects were found. We conducted subgroup analysis stratified by type ofcancer, region and time of appearance of side effects subsequently. No significant association between ATMAsp1853Asn and risk of radiotherapy adverse effects was found in any subgroup analysis. For TP53 Arg72Pro,variant C allele was associated with decreased radiotherapy adverse effects risk among Asian cancer patientsin the stratified analysis by region (OR=0.71, 95%CI: 0.54-0.93, p=0.012). No significant results were found inthe subgroup analysis of tumor type and time of appearance of side effects. Conclusions: The TP53 Arg72ProC allele might be a protective factor of radiotherapy-induced adverse effects among cancer patients from Asia.Further studies that take into consideration treatment-related factors and patient lifestyle including environmentalexposures are warranted.http://journal.waocp.org/article_30330_fc6c9d78c62de12b2de167e564c59d2e.pdfATMTP53PolymorphismsMeta-analysisradiotherapyAdverse effectstoxicityengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106831069030331Refining and Validating a Two-stage and Web-based Cancer Risk Assessment Tool for Village Doctors in ChinaThe big gap between efficacy of population level prevention and expectations due to heterogeneity andcomplexity of cancer etiologic factors calls for selective yet personalized interventions based on effective riskassessment. This paper documents our research protocol aimed at refining and validating a two-stage and webbasedcancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifyingindividuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequatesensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity forfarmers and village doctors. The protocol adopted a modified population-based case control design using 72,000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for externalvalidation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, familyhistory, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings,physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies likeempirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and externalvalidation using concordance statistics, predictive values, etc..http://journal.waocp.org/article_30331_fe6d3b0cde9d0b4a840a47ebc254b978.pdfcancerrisk indexPrediction modelcase controlpopulation-basedengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106911069530332Interaction of Tobacco Smoking and Chewing with Angiotensin Converting Enzyme (Insertion/Deletion) Gene Polymorphisms and Risk of Lung Cancer in a High Risk Area from Northeast IndiaBackground: Association of angiotensin converting enzyme (ACE) gene polymorphisms with lung cancersusceptibility remains uncertain and varies with ethnicity. Northeast India represents a geographically, culturally,and ethnically isolated population. The area reports an especially high rate of tobacco usage in a variety ofways of consumption, compared with the rest of the Indian population. Materials and Methods: We conducteda population based case control study in two major high risk region for lung cancer from Northeast India. Atotal of 151 consecutive lung cancer cases diagnosed histopathologically and equal numbers of controls wererecruited with record of relevant sociodemographic information. Blood samples were collected and processedto identify ACE gene polymorphism. Results: Significantly higher (40.4 % vs 29.1%, OR=1.97, CI=1.04-3.72;p=0.037) prevalence of the ACE II genotype was observed among lung cancer cases. Smoking was significantlyassociated with increased risk of lung cancer (OR=1.70, CI=1.02-2.81; p=0.041). An enhanced risk was alsoobserved for interaction of ACE II genotype with tobacco smoking (OR=4.09, CI=1.51-11.05; p=0.005) andchewing (OR=3.68, CI=1.22-11.13; p=0.021). Conclusions: The present study indicates significant association sof the ACE II genotype with lung cancer in high risk Northeast India.http://journal.waocp.org/article_30332_27361904b2f532c488523a3ae6272b0a.pdfAngiotensin Converting EnzymebradykininLung cancerPolymorphismsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524106971070330334Association between Laryngeal Squamous Cell Carcinoma and Polymorphisms in Tumor Necrosis Factor Related Apoptosis Induce Ligand (TRAIL), TRAIL Receptor and sTRAIL LevelsThe laryngeal squamous cell carcinoma (LSCC) is one of the most common malignant tumors occurringin the head and neck. Tumor necrosis factor related apoptosis induce ligand (TRAIL) and TRAIL-receptors(DR4, DR5, DcR1, DcR2) are known as important members of TRAIL-mediated biochemical signaling pathway.Associations between polymorphisms in these genes and clinicopathological characteristics of human laryngealcarcinoma are not well defined. This study therefore aimed to investigate a possible relationship among the TRAILand TRAIL-DR4 polymorphisms and sTRAIL levels in the risk or progression of LSCC. A total of 99 patientswith laryngeal cancer and 120 healthy subjects were enrolled in the study. DR4 C626G and TRAIL 1595 C/Tgenotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)analysis and sTRAIL levels were measured by ELISA. There were significant differences in the distribution ofDR4 C626G genotypes and frequencies of the alleles between laryngeal cancer patients and controls (phttp://journal.waocp.org/article_30334_34ea07e0ad3a133e068802941643c375.pdfLaryngeal cancerTRAILDR4sTRAILRiskprogressionPolymorphismTurkeyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107051071130335Oral and IV Dosages of Doxorubicin-Methotrexate loaded-Nanoparticles Inhibit Progression of Oral Cancer by Down-Regulation of Matrix Methaloproteinase 2 Expression in VivoOral cancer is one of the most common and lethal cancers in the world. Combination chemotherapy coupledwith nanoparticle drug delivery holds substantial promise in cancer therapy. This study aimed to evaluate theefficacy and safety of two dosages of our novel pH and temperature sensitive doxorubicin-methotrexate-loadednanoparticles (DOX-MTX NPs) with attention to the MMP-2 mRNA profile in a 4-nitroquinoline-1-oxide inducedoral squamous cell carcinoma (OSCC) model in the rat. Our results showed that both IV and oral dosages ofDOX-MTX NP caused significant decrease in mRNA levels of MMP-2 compared to the untreated group (p0.05). Our resultsindicated that IV dosage of MTX-DOX is more effective than free DOX (12 fold) in inhibiting the activity ofMMP-2 in OSCCs (Phttp://journal.waocp.org/article_30335_11ec636af425d04598efb4177d2f0c7c.pdfMMP-2DOX-MTX-nanoparticlesOral Squamous Cell Carcinomaoral and IV dosageengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107131071830337Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular CarcinomaPurpose: To investigate the prognostic value of serum amyloid A (SAA) in patients with hepatocellularcarcinoma (HCC) undergoing surgery. Materials and Methods: Preoperative serum samples of 328 patients withHCC who underwent curative resection and of 47 patients with benign liver lesion were assayed. Serum levelsof SAA were measured by enzyme-linked immunosorbent assay and its correlations with clinicopathologicalcharacteristics and survival were explored. Results: Levels of SAA were significantly higher in patients withHCC than those with benign liver lesion. There were strong correlations between preoperative serum SAA leveland tumor size and more advanced BCLC stage. On univariate analysis, elevated SAA was associated withreduced disease-free survival and overall survival (p=0.001 and 0.03, respectively). Multivariate analyses showedthat serum SAA level was an independent prognostic factor for overall survival (hazard ratio 2.80, p=0.01).Conclusions: High SAA serum level is a novel biomarker for the prognosis of HCC patients.http://journal.waocp.org/article_30337_d2401e6f67a2a98a2f79baac5d89a9e2.pdfSerum amyloid AHepatocellular carcinomaprognosisengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107191072230339Common Genetic Variations in the MUC5AC Gene are Not Related to Helicobacter pylori Serologic StatusSeveral lines of evidence suggest that MUC5AC genetic polymorphisms might confer susceptibility to H. pyloriinfection and therefore gastric cancer risk. We here assessed the association of common polymorphisms in theMUC5AC gene with H. pylori seroprevalence using an LD-based tagSNP approach in a north-western ChineseHan population. A total of 12 tagSNPs were successfully genotyped among 281 unrelated ethnic Han Chinese whohad no cancer history, and no identifiable gastric disease or genetic disease. No significant association betweenany alleles, genotypes or haplotypes and H. pylori seroprevalence was observed. Our results suggest that commongenetic variations in MUC5AC gene might not make a major contribution to the risk of H. pylori infection.http://journal.waocp.org/article_30339_7249ab25c61dc45fe97d13a9bbf3fbfc.pdfH. pylori - MUC5AC &#8211tagSNPs - seroprevalenceengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107231072830340Awareness and Attitude Relating to the Human Papilloma Virus and its Vaccines Among Pediatrics, Obstetrics and Gynecology Specialists in TurkeyBackground: To determine the level of knowledge on human papillomavirus (HPV) infection and vaccination,and the attitude towards HPV vaccination in pediatricians, obstetricians and gynecologists (OBG). Materialsand Methods: Participants were administered a 40-question survey, investigating the demographic properties,the knowledge on the HPV infection-vaccination and attitudes towards vaccination. Results: The study enrolleda total of 228 participants (131 pediatricians and 97 OBGs). At a rate of 99.6%, the participants agreed with thefact that the HPV infection was the most common sexually transmitted disease and 33.8% of the participants hadthe opinion that the HPV vaccination should be administered only in women. The lowest level of HPV vaccinerecommendation was among the pediatrics specialists (59.4%, p=0.012). When asked whether they would havetheir daughters receive HPV vaccination, 79.5% of the participants answered favorably; this rate was 36.7%for the sons. At a rate of 59.5% of the participants thought that the HPV vaccine needed to be included in thenational vaccine schedule. Most of the participants (91.6%) had the idea that reduction of the vaccine costswould increase the vaccination frequency. Conclusions: We observed that the consideration of the costs and theprejudices relating to the inefficacy of vaccination as well as the inadequate level of knowledge were involved inthe physicians’ resistance to HPV vaccination. We believe that the healthcare professionals should be informedadequately to overcome false beliefs, thereby ensuring success of the HPV vaccine upon inclusion in the nationalvaccine schedule in the future.http://journal.waocp.org/article_30340_eace75b1903094932f9a3f46f198b395.pdfAttitudeawarenessHuman papillomavirusImmunizationobstetrics & gynecologyPediatricsvaccinesengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107291073330342Risk Factors for Clinical Metastasis in Men Undergoing Radical Prostatectomy and Immediate Adjuvant Androgen Deprivation TherapyBackground: Adjuvant androgen deprivation therapy (ADT) is a treatment option for prostate cancer(PC) patients after radical prostatectomy (RP). Although it can achieve a good progression-free survival rate,some patients still develop clinical metastasis. We here investigated risk factors of clinical metastasis in postprostatectomypatients who received immediate adjuvant ADT. Materials and Methods: We identified 197 patientswith non-metastatic PC who underwent RP at our institution between 2000 and 2012, followed by adjuvantADT. The associations of various clinicopathologic factors with clinical metastasis (primary endpoint) andcancer-specific survival (secondary endpoint) were assessed. Multivariate analysis was conducted using a Coxproportional hazards model. Median follow-up was 87 months after RP. Results: Nine (4.6%) patients developedclinical metastasis and six (3.0%) died from PC. Eight of nine metastatic patients had a pathologic Gleason score(GS) 9 and developed bone metastasis, while the remaining one had pathologic GS 7 and developed metastasisonly to para-aortic lymph nodes. On multivariate analyses, pathologic GS ≥9 and regional lymph node metastasis(pN1) were independent predictors of clinical metastasis and pathologic GS ≥9 was an independent predictor ofcancer-specific death. Conclusions: Pathologic GS ≥9 and pN1 were independent predictors of clinical metastasisin post-prostatectomy patients who received immediate adjuvant ADT. Furthermore, pathologic GS ≥9 was anindispensable condition for bone metastasis, which may imply that patients with GS ≤8 on adjuvant ADT areunlikely to develop bone metastasis.http://journal.waocp.org/article_30342_38349e710e70c842631d2816dd3f3d9a.pdfadjuvantAndrogen deprivation therapyclinical metastasisProstate Cancerradical prostatectomyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107351073830344Descriptive Epidemiology of Common Female Cancers in the North East India - a Hospital Based StudyBackground: Cancers of the breast, uterine cervix and ovary are common cancers amongst females ofNorth East India. Not much is known about the descriptive epidemiology of these cancers in our population.The present retrospective analysis was therefore performed. Materials and Methods: The data set available atthe hospital based cancer registry of a regional cancer center of North-East India, containing information onpatients registered during the period of January 2010 to December 2012, was applied. A total of 2,925 cases ofbreast, uterine cervix and ovarian cancer were identified. Results: Of the total, 1,295 (44.3%) were breast cancers,1,214 (41.5%) were uterine cervix and 416 (14.2%) ovarian cancer, median age (range) for breast, uterine cervixand ovary were 45 (17-85), 48 (20-91) and 45 years (7-80), respectively. Some 43.5% of cases with uterine cervixpatients were illiterate, 5.4% and 5.7% stage I in breast and cervix respectively and 96.4% of ovarian cancersin advanced stage. Conclusions: Improvement of female education can contribute to increase the proportion ofearly stage diagnosis of breast and uterine cervix in our population. Any population-based intervention for thedetection of cancers of breast, uterine cervix and ovarian cancer should be started early in our population.http://journal.waocp.org/article_30344_f947754c2b9c2f4d6d270bd6f1a3bbe5.pdfBreast cancerovarian canceruterine cervix cancerNorth East Indiastage at diagnosisEpidemiologyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107391074330345Elastography for Breast Cancer Diagnosis: a Useful Tool for Small and BI-RADS 4 LesionsThe present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US),elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective studyenrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasoundand elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologicresult obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard.Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off pointof 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC(receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound andelastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed highsensitivity, specificity, and accuracy for group II lesions (10mmhttp://journal.waocp.org/article_30345_429f5e409802b5aa62034dc3c2e786f6.pdfUltrasoundElastographybreast lesionsstrain ratioengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107451074830346Irinotecan as a Palliative Therapy for Metastatic Breast Cancer Patients after Previous ChemotherapyBackground: This analysis was conducted to evaluate the efficacy and safety of irinotecan based chemotherapyfor treatment of patients with metastatic breast cancer (MBC) who experienced disease progression after one tothree chemotherapy regimens, including at least one anthracycline- or taxane-based. Methods: Clinical studieswere identified using a predefined search strategy. Pooled response rates (RR) to treatment were calculated.Results: As irinotecan based regimens, 5 clinical studies which including 217 patients with refractory MBC wereconsidered eligible for inclusion, with irinotecan, cisplatin, capecitabine, or TS-1. Systemic analysis suggestedthat, in all patients, pooled RR was 48.8% (106/217) with irinotecan based regimens. Thrombocytopenia andleukocytopenia were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatmentrelated deaths occurred. Conclusion: This systemic analysis suggests that irinotecan based regimens are beneficialand safe for treating patients with MBC after other chemotherapy.http://journal.waocp.org/article_30346_23c3ecf75e13326d4a08d25584d455e8.pdfMetastatic breast cancerprevious chemotherapyIrinotecanpalliative therapyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107491075530347Assessment of the Effects of Breast Cancer Training on Women Between the Ages of 50 and 70 in Kemalpasa, TurkeyBackground: In both developed and developing countries; breast cancer is the major cancer observed inwomen. The aim of this study was to assess the effect of nursing and mammographic intervention on womenwith breast cancer between the ages of 50 and 70. Materials and Methods: A training program, which was quasiexperimentaland had a pretest-protest design, was applied in Kemalpaşa district of Izmir, between October2008 and August 2010. The target population was women between the ages of 50 and 70, who were registeredin the list of 3rd Family Medicine Unit in Izmir’s Kemalpaşa metropolis. A total of 106 women who were inconformity with the study criteria participated in the study. Research data were collected through home visitsthat included face-to-face interviews; Ministry of Health education material and video films were modified andused for the training. Data analysis was performed through 82 women who were paired at the first and thesecond phase. Results: It was observed that although the rate of breast self examination significantly increasedafter the training (p=0.022), the rate of clinical breast examination (p=0.122) and mammographic screening(p=0.523) did not. Differences in the stages of change after training were found to be statistically significant(phttp://journal.waocp.org/article_30347_cef1f01635ec2782ec51e88d0606637f.pdfnursing interventionsBreast cancerbehavior change- mammography- TurkeyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107571076230349Cervical Screening Using Visual Inspection with Acetic Acid (VIA) and Treatment with Cryotherapy in FijiThe purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to recordnormative values for indicators anticipated in similar low resource settings. Women aged 30-49 years weretargeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva,Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to agynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway.Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) comparedto Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicatedsignificantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of thoseexamined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, withminor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, andin those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significantcomplications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelialneoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIAscreening program for other similar low resource settings.http://journal.waocp.org/article_30349_5da462421332fdce569fa166cb49c32c.pdfcervical cancerCryotherapyFijiScreeningVisual inspectionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107631076830351Incidence and Predictors of Inadequate Bowel Preparation before Elective Colonoscopy in Thai PatientsBackground: The incidence of inadequate bowel preparation before elective colonoscopy in this region hasnever been studied. Materials and Methods: The authors prospectively described the incidence and factors relatedto inadequate bowel preparation in Thammasat university hospital. Bowel preparation quality was accessedby using Aronchick scale. Factors associated with inadequate bowel preparation were also recorded. Results:Two hundred patients undergoing elective outpatient colonoscopy were enrolled. Inadequate and fair bowelpreparation was documented in 9 and 43%, respectively. Factors associated with inadequate bowel preparationwere incomplete cleansing agent ingestion (odds ratio 7.7; 95%CI 1.62-36.64) and patient’s unrecognizationof vegetable avoidance (odds ratio 3.26; 95%CI 1.14-9.28). Conclusions: Compared with previous reported,inadequate bowel preparation was seen less in our study, however, more patients with fair bowel preparationwas documented. Further study aiming at investigating the type and amount of fiber contained in diet beforeelective colonoscopy should be commenced.http://journal.waocp.org/article_30351_70dfbe6c6809cdf1e18706797299a6d6.pdfBowel Preparationincidencepredictorlow-fiber dietengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107691077230352Anti-VEGF Therapy with Bevacizumab - Limited Cardiovascular ToxicityPurpose: This analysis was conducted to evaluate cardiovascular toxicity of commonly used anti-VEGFtherapeutic agent, bevacizumab, in treating patients with cancer. Methods: Clinical studies evaluating the efficacyand safety of bevacizumab-based regimens on response and safety for patients with cancer were identified usinga predefined search strategy, allowing cardiovascular toxicity and other side effects of treatment to be estimated.Results: In bevacizumab based regimens, 4 clinical studies including 282 patients with advanced cancer (includinggliomas, cervical, breast and ovarian cancer) were considered eligible for inclusion. These bevacizumab-basedregimens included docetaxel, irinitecan and carboplatin. Systematic analysis suggested that, of 282 patientstreated by bevacizumab based regimens, hypertension and thrombo-embolism occurred in 2.5% (7/282), whileonly 3 patients reported cardiovascular events (1.1%). No treatment related death occurred in bevacizumabbased treatment.Conclusion: This systemic analysis suggests that bevacizumab based regimens are associatedwith reasonable and accepted cardiovascular toxicity when treating patients with gliomas, cervical, breast andovarian cancer.http://journal.waocp.org/article_30352_905b72c9261a2281525c2e977c226b66.pdfAnti-VEGF therapyBevacizumabcardiovascular toxicityengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107731077730355Legumain Protein as a Potential Predictive Biomarker for Asian Patients with Breast CarcinomaBackground: Treatment for breast cancer is mainly performed by surgical resection of primary tumors andchemotherapy. However, after tumor invasion and metastases, breast cancer is hard to control. Clarification ofthe pathogenic mechanisms would be helpful to the prognosis or therapy for the breast cancer. The aim of thisstudy is to investigate the clinical and prognostic implications of legumain protein Materials and Methods: Inthis study, we examined mastectomy specimens from 114 breast cancer and matching, 26 adjacent non-canceroustissues using immunohistochemistry. Results: The results indicated that positive expression of legumain proteinin breast cancer was 51.8 % (59/114) and the positive expression of legumain protein in adjacent non-canceroustissue was 11.5% (3/26). It appeared to be related with lymph node metastasis of breast cancer (p=0.02) andcorrelation analysis indicated that legumain expression was correlated positively with the estrogen receptor (ER)and mutant-type p53 expression (both phttp://journal.waocp.org/article_30355_a8b67700c28534275d93e0ddffc360f4.pdfBreast cancerlegumainprognostic biomarkerpositive expressionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107791078230356Epidemiology of Pancreatic Cancer in Vojvodina Province in SerbiaPurpose: Analysis of descriptive epidemiological characteristics of pancreatic cancer in Vojvodina, Serbia.Materials and Methods: The study covers population of Vojvodina in the period from 2000 to 2009. The methodused for data processing was the descriptive. The data, referring to a specified period of time, were analyzedfrom chronological and demographic aspects and according to histological diagnosis. Results: In the periodfrom 2000 to 2009, there were 2,108 registered cases of pancreatic cancer of which 1,886 had a fatal outcome.Standardized incidence rates varied between 5.7 and 9.1 per 100,000 population in males and between 4.2 and5.3 in females. Linear incidence trends in males in the specified period of time, based on crude (r=0.7883, phttp://journal.waocp.org/article_30356_2232669c78ccfe4a8afd70cb0496aad6.pdfpancreascancerEpidemiologyincidenceMortalityTrendpreventionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107831078630358Effectiveness of Tobacco Education for Pharmacy Students in IndonesiaBackground: Smoking remains the major preventable cause of death worldwide, especially cancer-relateddeath. Evidence clearly indicates that tobacco-related morbidity and mortality is reduced by smoking cessation.Pharmacists are well-positioned to provide tobacco cessation services an involvement of pharmacists in smokingcessation is encouraged by several organizations. While Indonesia’s prevalence of smoking is in the first rank inAsian countries, none of the pharmacy schools in Indonesia are currently offering tobacco-related courses in theirexisting curricula at present. Our study aimed to develop and to evaluate the effectiveness of tobacco education(TE) for pharmacy students in Indonesia. Materials and Methods: A 6-hour TE was developed and evaluatedusing pre-test/post-test with control group design. A total of 137 fifth-year pharmacy students at Gadjah MadaUniversity (GMU), Yogyakarta, were chosen as an intervention group while a total of 105 fifth-year students ofIslamic University of Indonesia, (UII) served as the control group. Knowledge, perceived-role, self-efficacy, andability to perform counseling using the 5A’s framework were evaluated. Results: A significant improvement (P http://journal.waocp.org/article_30358_b75c7f463dd9ac1005b996aa46d6e21e.pdfsmoking cessationeducationpharmacy studentpharmaceutical careindonesiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107871079030359Ovarian Cancer in Iranian Women, a Trend Analysis of Mortality and IncidenceBackground: Ovarian cancer is an important cause of mortality in women. The aim of this study was toevaluate the incidence and mortality rates and trends in the Iranian population and make predictions. Materialsand Methods: National incidence from Iranian annual of National Cancer Registration report from 2003 to 2009and National Death Statistics reported by the Ministry of Health and Medical Education from 1999 to 2004 wereincluded in this study. A time series model (autoregressive) was used to predict the mortality for the years 2007,2008, 2012 and 2013, with results expressed as annual mortality rates per 100,000. Results: The general mortalityrate of ovarian cancer slightly increased during the years under study from 0.01 to 0.75 and reaching plateauaccording to the prediction model. Mortality was higher for older age. The incidence also increased during theperiod of the study. Conclusions: Our study indicated remarkable increasing trends in ovarian cancer mortalityand incidence. Therefore, attention to high risk groups and setting awareness programs for women are neededto reduce the associated burden in the future.http://journal.waocp.org/article_30359_0a1b7a16b7376727e7c7459ad58eecc5.pdfovarian cancerMortalityincidenceTrend AnalysisIranengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107911079530306Comparison of Clinical Characteristics Between Benign Borderline and Malignant Phyllodes Tumors of the BreastBackground: Phyllodes tumors of the breast are rare fibroepithelial lesions, so relatively little is known aboutthis disease entity. The present study was designed to identify differences in clinical features between benignborderline and malignant phyllodes tumors. Materials and Methods: Data from 246 women with phyllodestumors of the breast treated in Cancer Hospital Chinese Academy of Medical Sciences between 2002 and 2012were collected and analyzed, including age at presentation, age at treatment, course, size of primary tumor,location, histological type, type of surgery and treatment, local recurrence, distant metastasis, fibroadenomahistory, disease-free survival and number of mitosis per 10hpf. There are 125 (55%) benign, 55 (24%) borderlineand 47 (21%) malignant tumors. Results: In univariate analysis, average age at presentation, average age attreatment, size of primary tumor, ulceration or not, type of primary surgery, distant metastasis and number ofmitosis per 10 hpf turned out to be statistically different among the three PT types (p=0.014, 0.018, http://journal.waocp.org/article_30306_cfbf34f82226cd8e7c2fc28825209e78.pdfPhyllodes tumors of the breastBenignborderlineMalignantdisease free survivalrecurrenceengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524107971080130308Identification and Functional Analysis of Differentially Expressed Genes Related to Metastatic OsteosarcomaBackground: To explore the molecular mechanisms of metastatic osteosarcoma (OS) by using the microarrayexpression profiles of metastatic and non-metastatic OS samples. Materials and Methods: The gene expressionprofile GSE37552 was downloaded from Gene Expression Omnibus database, including 2 human metastaticOS cell line models and 2 two non-metastatic OS cell line models. The differentially expressed genes (DEGs)were identified by Multtest package in R language. In addition, functional enrichment analysis of the DEGs wasperformed by WebGestalt, and the protein-protein interaction (PPI) networks were constructed by Hitpredict,then the signal pathways of the genes involved in the networks were performed by Kyoto Encyclopaedia of Genesand Genomes (KEGG) automatic annotation server (KAAS). Results: A total of 237 genes were classified asDEGs in metastatic OS. The most significant up- and down-regulated genes were A2M (alpha-2-macroglobulin)and BCAN (brevican). The DEGs were significantly related to the response to hormone stimulus, and the PPInetwork of A2M contained IL1B (interleukin), LRP1 (low-density lipoprotein receptor-related protein 1) andPDGF (platelet-derived growth factor). Furthermore, the MAPK signaling pathway and focal adhesion weresignificantly enriched. Conclusions: A2M and its interactive proteins, such as IL1B, LRP1 and PDGF may becandidate target molecules to monitor, diagnose and treat metastatic OS. The response to hormone stimulus,MAPK signaling pathway and focal adhesion may play important roles in metastatic OS.http://journal.waocp.org/article_30308_58d1c376c061558e302d938caca4388a.pdfMetastatic osteosarcomaDifferentially expressed genesinteraction networkpathway enrichmentengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108031080830314p16INK4A Expression in Squamous Cell Carcinomas of the Vagina and the Vulva in Tunisian WomenBackground: The role of p16INK4A expression in uterine cervix cancer is well established. In the remainingfemale lower genital tract cancers, the importance of p16INK4A up-regulation is less clear. In our study, we analyzedthe role of p16INK4A expression and HPV infection in carcinomas of the vulva and the vagina in Tunisian women.Materials and Methods: We conducted a retrospective study of 30 carcinomas including 15 vulvar squamouscell carcinomas (SCCs) and 15 vaginal SCCs. Immunohistochemistry was used to determine p16INK4A expression.HPV detection and typing was by in situ hybridization. Results: p16INK4A expression was detected in 86.7% ofvaginal SCCs with a strong and diffuse immunostaining in 60% of cases, and also in 73.3% of vulvar SCCswith focal immunoreactivity in 53.3% The association between p16INK4A expression and HPV infection wassignificant in vaginal SCCs (p=0.001) but not vulvar SCCs (p>0.05). Conclusions: p16INK4A expression could beused as a useful marker for HPV positivity in vaginal SCCs similar to that described in uterine cervix cancers.However, our data support the presence of 2 different mechanisms for p16INK4A expression in HPV-related andHPV-unrelated vulvar carcinomas.http://journal.waocp.org/article_30314_db37fae8c5cf5dafb95f3a1113c314fa.pdfHPV infectionp16INK4A expressionsquamous cell carcinomasvaginaVulvaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108091081230316Comparison of Detection Sensitivity for Human Papillomavirus between Self-collected Vaginal Swabs and Physician-collected Cervical Swabs by Electrochemical DNA ChipBackground: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerouschanges in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test forHPV as they are more acceptable and preferred for use in certain settings. The objective of this study was tocompare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materialsand Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytologyfrom Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups:29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with lowgradesquamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL).Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collectedswabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2%of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% ofphysician-collected swabs were positive for HPV. Concordance was relatively high between results from selfcollectedand physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions:HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening forcervical cancer in a population who might otherwise avoid this important preventive examination due toembarrassment, discomfort, and anxiety.http://journal.waocp.org/article_30316_a39405f1e4f1e36d051f4d44aa63e1fb.pdfHPVHPV genotypingself-collectedelectrochemical DNA chipengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108131081730318Prognostic Significance of Nestin Expression in pT1 High-Grade Bladder Urothelial Carcinoma Patients Treated with Intravesical BCGBackground: Possible roles of nestin expression in terms of predicting intravesical BCG therapy response inT1 high grade bladder cancer patients were investigated. Materials and Methods: T1 high grade bladder cancerpatients who were treated with intravesical BCG between 1990-2009 were included. Immunohistochemical stainingfor nestin expression was performed. Nestin(+) and nestin(-) patients were compared in terms of recurrenceand progression rates. Results: Sixty-three patients were included and median follow-up time was twenty-fivemonths. After staining; 33 patients (52.4%) were classified as nestin (+) and 30 (47.6%) as (-). Nestin (+) patientswere more likely to recur compared to nestin (-) patients (60.6% vs. 30%, phttp://journal.waocp.org/article_30318_9af20d165cccbc2a7f87c7c16e21b16b.pdfBladder cancerBCG treatmentresponsenestin expressionengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108191082430319A Novel All-trans Retinoid Acid Derivative Induces Apoptosis in MDA-MB-231 Breast Cancer CellsAims: To explore the effect and probable mechanism of a synthetic retinoid 4-amino-2-tri-fluoromethylphenylester (ATPR) on apoptosis of MDA-MB-231 breast cancer cells. Materials and Methods: MTT assayswere performed to measure the proliferation of MDA-MB-231 cells treated with different concentrations of alltransretinoic acid (ATRA) and ATPR. Morphologic changes were observed by microscopy. The apoptosis ratesand cell cycling of MDA-MB-231 cells treated with ATRA or ATPR were assessed using flow cytometry analysis.Expression of retinoic acid receptor and phosphorylation of ERK, JNK, p38 proteins were detected by Westernblotting. Results: Treatment of the cells with the addition of 15 μmol/L ATPR for 48 h clearly demonstratedreduced cell numbers and deformed cells, whereas no changes in the number and morphology were observedafter treatment with ATRA. The apoptosis rate was 33.2% after breast cancer MDA-MB-231 cells were treatedby ATPR (15 μmol/L) whereas ATRA (15 μmol/L) had no apoptotic effect. ATPR inhibited the phosphorylationof ERK, JNK, and p38 while ATRA had no significant effect. ATPR inhibited the expression of BiP and increasedthe expression of Chop at the protein level compared with control groups, ATRA and ATPR both decreasedthe protein expression of RXR α, ATPR reduced the protein expression of RARβ and RXRβ while ATRA didnot decrease RARβ or RXRβ. Conclusions: ATPR could induce apoptosis of breast cancer MDA-MB-231 cells,possible mechanisms being binding to RARβ/RXRβ heterodimers, then activation of ER stress involving theMAPK pathway.http://journal.waocp.org/article_30319_de6828001430345f623af2997d323940.pdfBreast cancerATPRER stressMAPK pathwayretinoic acid receptorengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108251083030321Inhibitory Effects of Phenolic Alkaloids of Menispermum Dauricum on Gastric Cancer in VivoThe present study was conducted to investigate effects and mechanisms of action of phenolic alkaloids ofMenispermum dauricum (PAMD) on gastric cancer in vivo. In vitro, cell apoptosis of human gastric cancer cellline SGC-7901 was observed using fluorescence staining. In vivo, a mice model was constructed to observe tumorgrowth with different doses. Cell apoptosis was examined using flow cytometry and K-RAS protein expressionusing Western blotting. The mRNA expression of P53, BCL-2, BAX, CASPASE-3, K-RAS was examined byreal-time PCR. PAMD significantly suppressed tumor growth in the xenograft model of gastric cancer in a dosedependentmanner (phttp://journal.waocp.org/article_30321_68a11bcb6dda92d2e45a1bea9b62b2d2.pdfGastric cancercell apoptosisin vivoK-rasphenolic alkaloids of menispermumdauricumengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108311083630323Elevated Preoperative Platelet to Lymphocyte Ratio Associated with Decreased Survival of Women with Ovarian Clear Cell CarcinomaThis study was conducted to establish whether the preoperative platelet to lymphocyte ratio (PLR) ispredictive of survival of women with ovarian clear cell carcinoma (OCCC). A PLR > 300 was deemed elevated.Progression-free survival (PFS) was estimated using the Kaplan-Meier method. Cox proportional hazard analysiswas used to determine the independent effect of PLR. Thirty-six patients were reviewed. Elevated PLRs weremore commonly noted in patients with an advanced vs an early stage of disease (88.9% vs 11.1%). Women withelevated PLR carried a higher rate of disease progression during primary therapy than that those in the normalPLR group (44.4 vs 22.2%). The median PFS for patients with elevated PLR was notably worse than that forpatients with normal PLR (10 vs 34 months). Despite the impact of elevated PLR on PFS, it was found to bemarginally significant when controlling for commonly applied prognostic markers. It, however, trended towardsignificance (HR=4.76; 95%CI, 0.95-23.8). In conclusion, an elevated PLR appears to be directly associated withadverse survival rather than being a surrogate for other indicators of a poor prognosis. PLR may be a usefulbiomarker for predicting survival of women with OCCC and merits further large-scale studies.http://journal.waocp.org/article_30323_a8a640b5726eb381a88665f63b37634c.pdfovarian cancerclear cell carcinomaplatelet to lymphocyte rationSurvivalengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108371084030325Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care CenterTo assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were dividedinto three groups according to the platinum free interval as follows: platinum refractory that included the patientswith tumor progression during treatment; platinum resistant and platinum sensitive that included the patientswith tumor progression less than or more than six months, respectively. Clinical data for tumor progressionin epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 andDecember, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in theplatinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration ofneoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean totalnumber of chemotherapy regimens, the early stage patients, the patients with complete surgery and the survivingpatients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment aftertumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the medianoverall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant andplatinum sensitive groups, respectively (phttp://journal.waocp.org/article_30325_73862fdad170e9a6dbe8dfc0c4dd3bd6.pdfOvarian cancer recurrenceplatinum refractory / resistant / sensitiveOverall survivalengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108411084630327Pattern of Shisha and Cigarette Smoking in the General Population in MalaysiaBackground: Smoking is a primary risk factor for cancer development. While most research has focused onsmoking cigarettes, the increasing popularity of shisha or water pipe smoking has received less attention. Thisstudy measured the prevalence and risk factors for shisha and cigarette smoking and related knowledge. Materialsand Methods: This cross-sectional analytical study was conducted in Shah Alam, Malaysia. Participants aged ≥ 18years were selected from restaurants. Data regarding demographic variables, smoking patterns, and knowledgeabout shisha smoking were collected in local languages. Logistic regression was performed to assess risk factors.Results: Of 239 participants, 61.9 % were male and 99.2% revealed their smoking status. Some 57.4% weresmokers: 50.7% only cigarettes, 5.9% only shisha and 42% both. Mean age of starting cigarette smoking was17.5 ± 2.4 years and for shisha smoking 18.7 ± 2.0 years. In a univariate model, male gender, age 33-52 yearsand monthly income > MYR 4,000 increased the risk and unemployment and being a student decreased therisk. In a multivariate model, male gender increased the risk of smoking, while being a student decreased therisk, adjusting for age and income. The perception of shisha being less harmful than cigarettes was present in14.6% and 7.5% had the opinion that shisha is not harmful at all, while 21.7% said that it is less addictive thancigarettes, 39.7% said that shisha did not contain tar and nicotine, 34.3% said that it did not contain carbonmonoxide and 24.3% thought that shisha did not cause health problems. Conclusions: Prevalence of shishaand cigarette smoking is high in the general population in Malaysia and knowledge about shisha smoking isrelatively low. The findings of our study might have implications for understanding similarities and differencesin incidence of shisha and cigarette smoking in other cultural/geographic regions.http://journal.waocp.org/article_30327_32d28d73c0559197b3145c94bb2ab7a8.pdfshishacigaretterisk factorsgeneral populationMalaysiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108471085330329Identifying Differentially Expressed Genes and Screening Small Molecule Drugs for Lapatinib-resistance of Breast Cancer by a Bioinformatics StrategyBackground: Lapatinib, a dual tyrosine kinase inhibitor that interrupts the epidermal growth factor receptor(EGFR) and HER2/neu pathways, has been indicated to have significant efficacy in treating HER2-positivebreast cancer. However, acquired drug resistance has become a very serious clinical problem that hampers theuse of this agent. In this study, we aimed to screen small molecule drugs that might reverse lapatinib-resistanceof breast cancer by exploring differentially expressed genes (DEGs) via a bioinformatics method. Materials andMethods: We downloaded the gene expression profile of BT474-J4 (acquired lapatinib-resistant) and BT474(lapatinib-sensitive) cell lines from the Gene Expression Omnibus (GEO) database and selected differentiallyexpressed genes (DEGs) using dChip software. Then, gene ontology and pathway enrichment analyses wereperformed with the DAVID database. Finally, a connectivity map was utilized for predicting potential chemicalsthat reverse lapatinib-resistance. Results: A total of 1, 657 DEGs were obtained. These DEGs were enrichedin 10 pathways, including cell cycling, regulation of actin cytoskeleton and focal adhesion associate examples.In addition, several small molecules were screened as the potential therapeutic agents capable of overcominglapatinib-resistance. Conclusions: The results of our analysis provided a novel strategy for investigating themechanism of lapatinib-resistance and identifying potential small molecule drugs for breast cancer treatment.http://journal.waocp.org/article_30329_1f33e25d4d050e25634e545af93f39d1.pdfLapatinib-resistanceDifferentially expressed genesdysfunctional pathwayBreast cancerbioinformaticsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108551086030333Intravenous Flurbiprofen Axetil Enhances Analgesic Effect of Opioids in Patients with Refractory Cancer Pain by Increasing Plasma b-EndorphinBackground: The study aimed to investigate the analgesic effect of a combination of intravenous flurbiprofenaxetil and opioids, and evaluate the relationship between refractory pain relief and plasma β-endorphin levels incancer patients. Materials and Methods: A total of 120 cancer patients was randomly divided into two groups,60 patients took orally morphine sulfate sustained-release tablets in group A, and another 60 patients receivingthe combination treatment of intravenous flurbiprofen axetil and opioid drugs in group B. After 7 days, painrelief, quality of life improvement and side effects were evaluated. Furthermore, plasma β-endorphin levelswere measured by radioimmunoassay. Results: With the combination treatment of intravenous intravenousflurbiprofen axetil and opioids, the total effective rate of pain relief rose to 91.4%, as compared to 82.1% whenmorphine sulfate sustained-release tablet was used alone. Compared with that of group A, the analgesic effectincreased in group B (p=0.031). Moreover, satisfactory pain relief was associated with a significant increase inplasma β-endorphin levels. After the treatment, plasma β-endorphin level in group B was 62.4±13.5 pg/ml, whichwas higher than that in group A (45.8±11.2 pg/ml) (phttp://journal.waocp.org/article_30333_c3786834b7f575933ce7c3cd9aada481.pdfFlurbiprofen axetilMorphinerefractory cancer painanalgesic effectsβ-endorphinengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108611086530336Public Awareness and Knowledge of Oral Cancer in YemenBackground: Oral cancer is in increasing in incidence in Yemen and indeed worldwide. Knowledge regardingrisk factors and early signs in the general population can help in prevention and early detection of the disease.Purpose: The aim of this study was to assess the level of awareness and knowledge of oral cancer in the generalpopulation in Yemen. Materials and Methods: A cross-sectional survey using a self-administered questionnairewas conducted on Yemeni adults aged ≥15 years old. A total of 543 persons participated, the collected databeing analyzed using SPSS software. The significance level was set at phttp://journal.waocp.org/article_30336_2b0fc6ade3cb20d2a9cb822284184e94.pdfOral cancerknowledgepublic awarenessYemenengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108671086930338Educational Levels and Delays in Start of Treatment for Head and Neck Cancers in North-East IndiaBackground: There are various patient and professional factors responsible for the delay in start of treatment(SOT) for head and neck cancers (HNC). Materials and Methods: This retrospective study was conducted ondata for HNC patients registered at the hospital cancer registry in North-East India. All cases diagnosed duringthe period of January 2010 to December 2012 were considered for the present analysis. Educational levels of allpatients were clustered into 3 groups; illiterates (unable to read or write), qualified (school or high school leveleducation), and highly qualified (college and above). Results: In the present analysis 1066 (34.6%) patients wereilliterates, 1,869 (60.6%) patients were literates and 145 (4.7%) of all patients with HNC were highly qualified.The stage at diagnosis were stage I, seen in 62 (34.6%), stage II in 393 (12.8%), stage III in 1,371 (44.5%) andstage IV in 1,254 (40.7%) . The median time (MT) to the SOT from date of attending cancer hospital (DOACH)was, in illiterate group MT was 18 days, whereas in the qualified group of patients it was 15 days and in the highlyqualified group was 10 days. Analysis of variance showed there was a significant difference on the mean time forthe delay in SOT from DOACH for different educational levels (F=9.923, p=0.000). Conclusions: Educationallevel is a patient related factor in the delays for the SOT in HNCs in our population.http://journal.waocp.org/article_30338_3fe683e93a0cfce09eb76ddde57de781.pdfEducational levelsHead and neck cancerstreatment delayspatient factorsNorth-East IndiaengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108711087430341Quality of Life in Gestational Trophoblastic Neoplasia Patients after Treatment in ThailandBackground: Gestational trophoblastic neoplasia (GTN) is a malignant disease which occurs in women ofreproductive age. Treatment of GTN has an excellent outcome and further pregnancies can be expected. However,data concerning quality of life in these cancer survivor patients are limited. This study aimed to assess qualityof life in women who were diagnosed with GTN and remission after treatment, and to determine factors thatmay affect quality of life status. Materials and Methods: This cross sectional study was conducted from July2013 to May 2014 in the Gestational Trophoblastic Disease Clinic, King Chulalongkorn Memorial Hospital,Bangkok, Thailand. Patients who were diagnosed GTN and complete remission were recruited. Data collectionwas accomplished by interview with two sets of questionnaires, one general covering demographic data andthe other focusing on quality of life, the fourth version of Functional Assessment of Cancer Therapy (FACT-G).Descriptive statistics were used to determine general data and quality of life scores. Students t-test and oneway ANOVA were used to compare between categorical and continuous data. Results: Forty four patients wereenrolled in this study. The overall mean quality of life score (FACT-G) was 98.2. The overall FACT-G score wasnot significantly correlated with age, education level, stage of disease, treatment modalities, and time intervalfrom remission to enrollment. However, patients who needed further fertility showed significant lower FACT-Gscores in the emotional well-being domain (p=0.02). Conclusions: Overall quality of life scores in post-treatmentgestational trophoblastic neoplasia patients are in the mild impairment range. Patients who desire fertility sufferlower quality of life in the emotional well-being domain.http://journal.waocp.org/article_30341_a7c2a2419540afb4fe2c9f192516615d.pdfGestational trophoblastic diseaseTreatment outcomeQuality of lifeFACT-GengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108751087830343B3GNT2, a Polylactosamine Synthase, Regulates Glycosylation of EGFR in H7721 Human Hepatocellular Carcinoma CellsThe epidermal growth factor receptor (EGFR) is an important surface receptor with N-glycans in itsextracellular domain, whose glycosylation is essential for its function, especially in tumor cells. Here, wedemonstrated that polylactosamine is markedly increased in H7721 hepatocellular carcinoma cells after treatmentwith EGF, while it apparently declined after exposure to all-trans retinoic acid (ATRA). In the study of theenzymatic mechanism of this phenomenon, we explored changes in the expression of poly-N-acetyllactosamine(PLN) branching glycosyltransferases using RT-PCR. Among the four glycosyltransferases with alteredexpression, GnT-V was most elevated by EGF, while GnT-V and B3GNT2 were most declined by ATRA. Next,we conducted co-immunoprecipitation experiments to test whether B3GNT2 and EGFR associate with eachother. We observed that EGFR is a B3GNT2-targeting protein in H7721 cells. Taken together, these findingsindicated that the altered expression of B3GNT2 will remodel the PLN stucture of EGFR in H7721 cells, whichmay modify downstream signal transduction.http://journal.waocp.org/article_30343_f837c8e7164b42739da137ef50f3cd58.pdfB3GNT2EGFRpoly-N-acetyllactosamineglycosylationH7721 cellsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108791088230348Effect of Intraoperative Glucose Fluctuation and Postoperative IL-6, TNF-α, CRP Levels on the Short-term Prognosis of Patients with Intracranial Supratentorial NeoplasmsObjective: To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6),tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) levels on the short-term prognosis of patients withintracranial supratentorial neoplasms. Materials and Methods: Eighty-six patients undergoing intracranialexcision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation,the patients were divided into group A (glucose fluctuation 0.05). The glucoselevels in both groups at T1~T6 went up conspicuously compared with that at T0 (Phttp://journal.waocp.org/article_30348_4f52c2155bb3cf1e3e9698f453ab4b67.pdfGlucose fluctuationsupratentorial neoplasmsInterlukin-6Tumor Necrosis Factor-αC-reactive proteinengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108831088530350Neutrophil to Lymphocyte Ratio - Not an Independent Prognostic Factor in Patients with the Myelodysplastic SyndromePurpose: Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patientswith myelodysplastic syndrome (MDS). Materials and Methods: Between December 2009 and April 2014, 14female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included inthe study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation withmortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluatedwith adjustment for known confounding risk factors. Results: The mortality rate of the patient group was55%, and median survival was 18 months. There was no significant correlation between mortality and NLR ata median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there wasa significant correlation between mortality and pancytopenia (p=0.017). Conclusions: This first study of NLRand mortality did not show any significant correlation . In centres with limited access to genetic evaluation forthe presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than 50×109/lmay be poor prognostic markers in MDS patients.http://journal.waocp.org/article_30350_670f70e6c1bebbe8a8627b07a9aa7d02.pdfMyelodysplastic syndromeneutrophil/lymphocyte ratiocytopeniaprognosisengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108871089130353Helicobacter pylori Infection Impacts on Functional Dyspepsia in ThailandBackground: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even whenasymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most commongastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress arefrequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asiancountries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depressionon Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care centerin Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome IIIcriteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The HospitalAnxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was definedas positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FDpatients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patientswith PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety anddepression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depressionwere significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9,respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patientsand more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of ThaiFD patients and prevent the development of gastric cancer.http://journal.waocp.org/article_30353_b9ed697fc32f4ec15301f47fc909e068.pdfH. pylori infectionfunctional dyspepsiaGastric cancerThailandengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108931089830354Prognostic Value of MGMT Promoter Methylation and TP53 Mutation in Glioblastomas Depends on IDH1 MutationSeveral molecular markers have been proposed as predictors of outcome in patients with glioblastomas.We investigated the prognostic significance of O6-methylguanine-DNA methyltransferase (MGMT) promotermethylation and TP53 mutation status dependent on isocitrate dehydrogenase 1 (IDH1) mutation in glioblastomapatients. A cohort of 78 patients with histologically confirmed glioblastomas treated with radiation therapy andchemotherapy were reviewed retrospectively. We evaluated the prognostic value of MGMT promoter methylationand TP53 mutation status with regard to progression-free survival (PFS) and overall survival (OS). It was revealedthat mutations in IDH1, promoter methylation of MGMT, TP53 mutation, age, Karnofsky performance status(KFS), and extension of resection were independent prognostic factors. In patients with an IDH1 mutation, thosewith an MGMT methylation were associated with longer PFS (p=0.016) and OS (p=0.013). Nevertheless, thepresence of TP53 mutation could stratify the PFS and OS of patients with IDH1 wild type (p=0.003 and 0.029respectively, log-rank). The MGMT promoter methylation and TP53 mutation were associated with a favorableoutcome of patients with and without mutant IDH1, respectively. The results indicate that glioblastomas withMGMT methylation or TP53 mutations have improved survival that may be influenced by IDH1 mutation status.http://journal.waocp.org/article_30354_c1c09b1278b67e53b03336f41152e63e.pdfGlioblastomasIDH1 mutationMGMT promoter methylationTP53 mutationprognosisengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524108991090330357Role of PET/CT in Treatment Planning for Head and Neck Cancer Patients Undergoing Definitive RadiotherapyBackground: In this study, we aimed to investigate the benefits of 18F-deoxyglucose positron emissiontomography/computed tomography (FGD-PET/CT) imaging for staging and radiotherapy planning in patientswith head and neck cancer undergoing definitive radiotherapy. Materials and Methods: Thirty-seven headand neck cancer patients who had undergone definitive radiotherapy and PET/CT at the Uludag UniversityMedical Faculty Department of Radiation Oncology were investigated in order to determine the role of PET/CTin staging and radiotherapy planning. Results: The median age of this patient group of 32 males and 5 femaleswas 57 years (13-84years). The stage remained the same in 18 cases, decreased in 5 cases and increased in 14cases with PET/CT imaging. Total gross tumor volume (GTV) determined by CT (GTVCT-Total) was increasedin 32 cases (86.5%) when compared to total GTV determined by PET/CT (GTVPET/CT-Total). The GTV of theprimary tumor determined by PET/CT (GTVPET/CT) was larger in 3 cases and smaller in 34 cases comparedto that determined by CT (GTVCT). The GTV of lymph nodes determined by PET/CT (GTVLNPET/CT) waslarger in 20 cases (54%) and smaller in 12 cases (32.5%) when compared to GTV values determined by CT(GTVLNCT). No pathological lymph nodes were observed in the remaining five cases with both CT and PET/CT. Conclusions: We can conclude that PET/CT can significantly affect both pretreatment staging and assessedtarget tumor volume in patients with head and neck cancer. We therefore recommend examining such cases withPEC/CT before treatment.http://journal.waocp.org/article_30357_7cab1afe11840a0dc6e790c707cb90bd.pdfhead and neck cancerPET-CTradiotherapyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109051090930360Diagnostic value of Thyroglobulin Measurement with Fineneedle Aspiration Biopsy for Lymph Node Metastases in Patients with a History of Differentiated Thyroid CancerPurpose: The aim of this study was to evaluate the diagnostic value of FNA-Tg for detecting lymph nodemetastases in patients with a history of differentiated thyroid cancer (DTC). Materials and Methods: A total of58 patients with DTC diagnosis and evidence of single or multiple suspicious cervical lymph nodes were assessed.All underwent total or near-total thyroidectomy with (35 cases) or without (23 cases) radioiodine (RAI) ablation,followed by thyroid stimulating hormone (TSH) suppression therapy. A total of 68 lymph nodes were examined byultrasound-guided fine needle aspiration (US-FNA) for both cytological examination and FNA-Tg measurement.Serum Tg and anti-thyroglobulin antibody (TgAb) levels were also measured. Diagnostic performance includingsensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV) of FNAC and FNA-Tg werecalculated and compared. The Spearman’s rank correlation coefficient was used to estimate the relationshipbetween FNA-Tg and serum TgAb. Results: The FNA-Tg levels were significantly higher with DTC metastaticlymph nodes (median 927.7 ng/mL, interquartile range 602.9 ng/mL) than non-metastatic lymph nodes (median0.1 ng/mL, interquartile range 0.4 ng/mL) (phttp://journal.waocp.org/article_30360_88f1f6bd465b691df93eecbb5865b9c5.pdfDifferentiated thyroid cancer-fineneedle aspiration biopsycervical lymph node metastasesthyroglobulinengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109111091630361Steroidal Saponins from Paris polyphylla Suppress Adhesion, Migration and Invasion of Human Lung Cancer A549 Cells Via Down-Regulating MMP-2 and MMP-9Background: Tumor metastases are the main reasons for oncotherapy failure. Paris polyphylla (Chinese name:Chonglou) has traditionally been used for its anti-cancer actions. In this article, we focus on the regulation ofhuman lung cancer A549 cell metastases and invasion by Paris polyphylla steroidal saponins (PPSS). Materialsand Methods: Cell viability was evaluated in A549 cells by MTT assay. Effects of PPSS on invasion and migrationwere investigated by wound-healing and matrigel invasion chamber assays. Adhesion to type IV collagen andlaminin was evaluated by MTT assay. Expression and protease activity of two matrix metalloproteinases (MMPs),MMP-2 and MMP-9, were analyzed by Western blotting and gelatin zymography, respectively. Results: PPSSexerted growth inhibitory effects on A549 cells, and effectively inhibited A549 cell adhesion, migration andinvasion in a concentration-dependent manner. Western blotting and gelatin zymography analysis revealed thatPPSS inhibited the expression and secretion of MMP-2 and MMP-9 in A549 cells. Conclusions: PPSS has thepotential to suppress the migration, adhesion and invasion of A549 cells. PPSS could be a potential candidatefor interventions against lung cancer metastases.http://journal.waocp.org/article_30361_e5f8b545514bfaee5bfeb0383d383988.pdfParis polyphyllasteroidal saponinsLung cancermetastasisMMP-2MMP-9engAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109171092230363DEP Domain Containing 1 is a Novel Diagnostic Marker and Prognostic Predictor for Hepatocellular CarcinomaBackground: This study was conducted to determine DEPDC1 expression in hepatocelluar carcinomas (HCCs)and to reveal its potential role in diagnosis and prognosis of affected patients. Materials and Methods: DEPDC1expression at the mRNA level was detected by quantitative real-time PCR (qRT-PCR) in 205 cases of HCC andpaired adjacent normal liver tissues, and by semi-quantitative RT-PCR in 20 cases. Survival curves were obtainedby using Kaplan-Meier method and Log-rank test. Independent predictors associated with regard to diseasefree survival (DFS) and overall survival (OS) were identified using the Cox proportional hazard model. Results:High DEPDC1 mRNA levels were detected in 144 out of 205 cases (70.24%) of HCC, significantly associatedwith clinicopathological parameters, including tumor size (≥4cm), alpha-fetoprotein (≥100ng/ml), B-C of BCLCstage and recurrence. Kaplan-Meier survival analysis revealed that HCC patients with high DEPDC1 expressionhad poor OS and DFS. Multivariate analysis demonstrated that high DEPDC1 expression was an independentpredictor for OS (HR=1.651; 95% 95%CI, 1.041- 2.617; p=0.033) and DFS (HR=1.583; 95%CI, 1.01- 2.483;p=0.045). Conclusions: Our results indicate DEPDC1 might be a novel diagnostic marker and an independentprognostic predictor for HCC patients.http://journal.waocp.org/article_30363_0b917d0588ac784e118e5c6abdf42530.pdfHepatocellular carcinomaDEPDC1prognosisDiagnosisBiomarkerengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109231092630365Comparative Histopathological Characterization of Prostate Cancer in Saudi Patients by Conventional and 2005 ISUP Modified Gleason SystemsBackground: The aim of this study was to compare the characterization of prostate cancer using theconventional and 2005 ISUP modified Gleason systems. Materials and Methods: The study employed samplesfrom 40 prostate cancer patients with resection, biopsy and RP materials. The majority of cases (95%) comprisedadenocarcinoma of the prostate with a modified combined Gleason score of 7 in 20 of the cases (50%). Results:Upgrading of Gleason scores to a score of 7 occurred in more than 45% of the cases. Conclusion: The studysuccessfully showed that by the use of the 2005 ISUP modified Gleason system, score 6 cancers decreased from25% to 17.5% of cases, whereas score 7 cancers increased from 45% to 50%.http://journal.waocp.org/article_30365_782286d86c46bc382501161685943d83.pdfBackground: The aim of this study was to compare the characterization of prostate cancer using theengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109271093230367Predictors of Cancer Awareness among Older Adult Individuals in JordanBackground: Older age is associated with an increase in the incidence of cancer cases. Diagnosis and treatmentof cancer in older adults can be stressful because of health decline related to age, comorbidities and inadequatetreatment for pain and other symptoms of the disease. This survey is one of the unique studies in Jordan andin the Arab world that aimed at exploring the predictors of older adult individuals awareness towards cancer.Materials and Methods: A stratified random sampling technique was followed to reach a representative sample of753 participants. The questionnaire of the study consisted of parts regarding demographic variables, awarenessabout screening tests, and signs and symptoms of cancer. In addition, specific questions related to factors linkedto cancer were included. Cross-sectional design was adopted with face-to-face interviews at the interviewees’households. Results: The mean age of the participants was about 63 years; around 44% of them are above theage of 65 years. ‘Being convinced that having no health problem makes the individual feel safe and not at riskof getting cancer’ was the major reason for not doing a routine health check-up. Conclusions: The low levelsof awareness about cancer, as well as the low use of the screening methods were crucial outcomes of this study.Thus, raising the awareness among health care providers and policy makers in the country about older adults’perception of cancer is a high priority.http://journal.waocp.org/article_30367_f649ad87cd676382029ce907da7720cc.pdfawarenesscancerolder adultsperceptionJordanengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109331093530369Candida non albicans with a High Amphotericin B Resistance Pattern Causing Candidemia among Cancer PatientsBackground: Many scientists have reported Candida species to be of great concern because of the highfrequency that they colonize and infect human hosts, particularly cancer patients. Moreover, in the last decadesCandida species have developed resistance to many antifungal agents. Based on this, we aimed to identify anddetermine the prevalence of Candida spp from blood culture bottles among cancer patients and their antifungalresistance pattern. Materials and Methods: From the blood culture bottles isolation and identification of theCandida spp were performed by conventional microbiological techniques. The in vitro antibiotic resistance patternof the isolates was determined by CLSI guidelines. Genomic DNA was isolated and amplified. Each gene wasseparated by agar gel electrophoresis. Results: Identification of Candida spp was based on the presence of yeastcells in direct examination, culture and DNA extraction. Of the 68 blood samples collected during the studyperiod (April 2013 to October 2013), five (7.35%) were positive for the presence of Candida spp, 2 (40%) of whichwere identified as Candida albicans and 3 (60%) were Candida non-albicans. Conclusions: High resistance toamphotricin B was observed among all the Candida non-albicans isolates. Regular investigations into antifungalresistance will help us to get an updated knowledge about their antibiotic resistance pattern which may help thephysician in selecting the antibiotics for empirical therapy.http://journal.waocp.org/article_30369_6386d74022f77e1a98ba5fdfe2716405.pdfCandidemiaCancer patientsCandida non albicansMultiplex PCRamphotericin B resistanceengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109371094130372Association of Methylation of the RAR-β Gene with Cigarette Smoking in Non-Small Cell Lung Cancer with Southern-central Chinese PopulationPathogenesis of lung cancer is a complicated biological process including multiple genetic and epigeneticchanges. Since cigarette smoking is confirmed as the most main risk factor of non-small cell lung cancer (NSCLC),the aim of this study was to determine whether tobacco exposure plays a role in gene methylation. Methylationof the RAR-β gene were detected using methylation-specific polymerase chain reaction in DNA from 167 newlydiagnosed cases with NSCLC and corresponding 105 controls. A significant statistical association was found inthe detection rate of the promoter methylation of RAR-β gene between NSCLC and controls (x2=166.01; phttp://journal.waocp.org/article_30372_9f1a724b27d3b7159d77961a59372c64.pdfMethylationnon-small cell lung cancerRARβ genecigarette exposureengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109431094730374Correlation Study of Knowledge and Behavior Regarding Breast Care among Female Undergraduate Students in ChinaBackground: This study aimed to understand the relationship between knowledge level and behavior onbreast care in Chinese students, so as to provide strategies for improving the health education of breast care andsubsequently for aiding in breast cancer prevention. Materials and Methods: A self-designed questionnaire wasused to evaluate breast care knowledge level and characterize related behavior. Correlation analysis was conductedfor the knowledge level and behavior. The study was carried out using 597 female undergraduate students inmedical and non-medical colleges in Wuhu, China. Results: The average score of breast care knowledge was5.32±1.68 (5.62±1.68 and 5.00±1.68 for medical and non-medical students, respectively), with a greater score valuefor sophomores (5.59±1.72) than freshmen (5.18±1.65). The average score of breast care behavior was 2.21±1.13,again with a greater value in sophomores (2.37±1.15) than freshmen (2.21±1.13). A significant positive correlation(r=0.231, phttp://journal.waocp.org/article_30374_c934e16a1be40315b3f1f5fcf726d783.pdfChinaundergraduate studentsbreast careknowledgeBehaviorengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109491095530376Asparagus Polysaccharide and Gum with Hepatic Artery Embolization Induces Tumor Growth and Inhibits Angiogenesis in an Orthotopic Hepatocellular Carcinoma ModelLiver cancer is one of leading digestive malignancies with high morbidity and mortality. There is anurgent need for the development of novel therapies for this deadly disease. It has been proven that asparaguspolysaccharide, one of the most active derivates from the traditional medicine asparagus, possesses notableantitumor properties. However, little is known about the efficacy of asparagus polysaccharide as an adjuvantfor liver cancer chemotherapy. Herein, we reported that asparagus polysaccharide and its embolic agent form,asparagus gum, significantly inhibited liver tumor growth with transcatheter arterial chemoembolization (TACE)therapy in an orthotopic hepatocellular carcinoma (HCC) tumor model, while significantly inhibiting angiogenesisand promoting tumor cell apoptosis. Moreover, asparagine gelatinous possessed immunomodulatory functionsand showed little toxicity to the host. These results highlight the chemotherapeutic potential of asparaguspolysaccharide and warrant a future focus on development as novel chemotherapeutic agent for liver cancerTACE therapy.http://journal.waocp.org/article_30376_bdaf7a09f8fc01cffd84efe890ed3d75.pdfhepatocellular carcinoma (HCC)asparagus gumasparagus polysaccharideTACE therapyengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109571096030379Effects of the CYP2C19 Genetic Polymorphism on Gastritis, Peptic Ulcer Disease, Peptic Ulcer Bleeding and Gastric CancerBackground: The CYP2C19 genotype has been found to be an important factor for peptic ulcer healing andH. pylori eradication, influencing the efficacy of proton pump inhibitors (PPIs) and the pathogenesis of gastriccancer. The aim of this study was to investigate clinical correlations of the CYP2C19 genotype in patients withgastritis, peptic ulcer disease (PUD), peptic ulcer bleeding (PUB) and gastric cancer in Thailand. Materialsand Methods: Clinical information, endoscopic findings and H. pylori infection status of patients were assessedbetween May 2012 and November 2014 in Thammasat University Hospital, Thailand. Upper GI endoscopy wasperformed for all patients. Five milliliters of blood were collected for H. pylori serological diagnosis and CYP2C19study. CYP2C19 genotypes were determined by polymerase chain reaction (PCR) and restriction fragment lengthpolymorphism analysis (RFLP) and classified as rapid metabolizer (RM), intermediate metabolizer (IM) or poormetabolizer (PM). Results: A total of 202 patients were enrolled including 114 with gastritis, 36 with PUD, 50 withPUB and 2 with gastric cancer. Prevalence of CYP2C19 genotype was 82/202 (40.6%) in RM, 99/202 (49%) inIM and 21/202 (10.4%) in PM. Overall H. pylori infection was 138/202 patients (68.3%). H. pylori infection wasdemonstrated in 72% in RM genotype, 69.7% in IM genotype and 47.6% in PM genotype. Both gastric cancerpatients had the IM genotype. In PUB patients, the prevalence of genotype RM (56%) was highest followed byIM (32%) and PM(12%). Furthermore, the prevalence of genotype RM in PUB was significantly greater thangastritis patients (56% vs 36%: p=0.016; OR=2.3, 95%CI=1.1-4.7). Conclusions: CYP2C19 genotype IM was themost common genotype whereas genotype RM was the most common in PUB patients. All gastric cancer patientshad genotype IM. The CYP2C19 genotype RM might be play role in development of PUD and PUB. Furtherstudy in different population is necessary to verify clinical usefulness of CYP2C19 genotyping in developmentof these upper GI diseases.http://journal.waocp.org/article_30379_d979e0608719634557d0e8418ada2b25.pdfCYP2C19 genotypeGastritispeptic ulcer diseaseGastric cancerengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109611096630362Performance of HPV DNA Testing with Hybrid Capture 2 in Triaging Women with Minor Cervical Cytologic Abnormalities (ASC-US/LSIL) in Northern ThailandBackground: Minor cervical cytologic abnormalities include atypical squamous cells of undeterminedsignificance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). Approximately 10-20% of womenwith minor cytologic abnormalities have histologic high-grade squamous intraepithelial or worse lesions (HSIL+).In Thailand, women with minor cytologic abnormalities have a relatively high risk of cervical cancer, and referralfor colposcopy has been suggested. A triage test is useful in the selection of women at risk for histologic HSIL+ toreduce the colposcopy burden. The aim of this study was to assess the performance of high-risk HPV DNA test intriage of women with minor cytologic abnormalities in northern Thailand. Materials and Methods: All womenwith ASC-US/LSIL cytology who were referred to our colposcopy clinic from October 2010 to February 2014were included. HPV DNA testing was performed using Hybrid Capture 2 (HC2). All patients received colposcopicexamination. Accuracy values of HC2 in predicting the presence of histologic HSIL+ were calculated. Results:There were 238 women in this study (121 ASC-US and 117 LSIL). The HC2 positivity rate was significantlyhigher in the LSIL group than in ASC-US group (74.8% versus 41.0%, p50 years with ASC-US cytology. An increase in thecut-off threshold for positive HC2 resulted in a substantial decrease of sensitivity and negative predictive value.Conclusions: HPV DNA testing with HC2 shows very high sensitivity and negative predictive value in triage ofwomen with minor cervical cytologic abnormalities in northern Thailand. An increase of the cut-off thresholdfor HC2 triage is not recommended in this region.http://journal.waocp.org/article_30362_880c345b261eedab82329b8644d81a9e.pdfcervical cancerCytologyASC-USLSILTriageHPV DNA testThailandengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109671097030364Efficacy and Survival-associated Factors with Gefitinib Combined with Cisplatin and Gemcitabine for Advanced Nonsmall Cell Lung CancerObjective: To analyze the efficacy and survival associated factors of gefitinib combined with cisplatin andgemcitabine for advanced non-small cell lung cancer. Materials and Methods: A total of 57 patients with advancednon-small cell lung cancer (NSCLC), who received platinum-based chemotherapy regimens for more than 1 cycle,were treated with gefitinib combined with cisplatin and gemcitabine until disease progression. Efficacy, survivaltime and adverse reactions were observed. The Kaplan-Meier method was adopted for analysis of survival andCox regression for associated influencing factors. Results: The patients were followed up until October 31, 2013,and the median follow-up time was 19 months. Of 57 patients, there were 4 (7.0%) with complete remission (CR),8 (14.0%) with partial remission, 31 (54.4%) with stable disease, and 14 (24.6%) with disease progression. Theremission rate was 21.1% and the disease control rate was 75.4%. The median progression-free survival (PFS)time and the median overall survival time were 10 months and 15.2 months. The one-year, two-year and threeyearsurvival rates were 47.4%, 23.3% and 10.0%. Gender and pathological types were the independent riskfactors influencing PFS time (P=0.028, P=0.009). Tumor pathological type and early efficacy were independentfactors for the prognosis (P=0.018, P=0.000). Adverse reactions were mostly rashes of Ⅰ~Ⅱ degree and diarrheaand slightly increasing level of aminopherase. The skin adverse event incidence of Ⅲ degree or above was1.8% (1/57) and brain metastasis was foudn in 31.6% (18/57). Conclusions: Gefitinib combined with cisplatinandgemcitabine, is effective for patients with Ⅲb~Ⅳ NSCLC who received multiple cycles of chemotherapy.http://journal.waocp.org/article_30364_a9a4bc3cf19de0efdd2b0ece0178b9a9.pdfNSCLCgefitinibcisplatinGemcitabineAdenocarcinomaSurvivalassociated influencing factorsengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109711097530366Effect of Laparoscopic Nerve-sparing Radical Hysterectomy on Bladder Function, Intestinal Function Recovery and Quality of Sexual Life in Patients with Cervical CarcinomaObjective: To investigate bladder and intestinal function recovery and quality of sexual life after laparoscopicnerve-sparing radical hysterectomy (LNRH) for treatment of early invasive cervical carcinoma. Methods:Subjects included patients who underwent radical hysterectomy by laparotomy who were randomly assignedto 2 groups: 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy (LRH). Weassessed the patients general clinical information, surgical characteristics, pathological findings, and adjuvanttherapies. A urodynamic study was used to assess bladder function. Intestinal function recovery and qualityof sexual life were evaluated by questionnaire. Results: No significant differences were found in age, surgerycharacteristics, pathological findings, adjuvant therapies, and main adverse effects between the 2 groups. Themean duration of the postoperative catheterization (DPC) in group LNRH was shorter than that in group LRH(P < 0.001). The maximum flow rate, maximum cystometric capacity , maximum detrusor pressure and urinarycomplications in group LNRH were better than those in group LRH. The quality of sexual life evaluated accordingto the female sexual function index (FSFI) was better in group LNRH than in those who underwent LRH. Theintestinal function of patients in group LNRH also recovered better compared with patients in group LRH.http://journal.waocp.org/article_30366_cfc602b15687b3a325be01c4991d3587.pdfcervical cancerlaparoscopic nerve-sparing radical hysterectomybladder functionquality of sexual lifeengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109771097930368Cantharidin Combined with Chemotherapy for Chinese Patients with Metastatic Colorectal CancerBackground: This systematic analysis was conducted to evaluate the efficacy and safety of cantharidincombined with chemotherapy in treating Chinese patients with metastatic colorectal cancer. Methods: Clinicalstudies evaluating the efficacy and safety of cantharidin combined with chemotherapy on response and safetyfor Chinese patients with colorectal cancer were identified using a predefined search strategy. Pooled responserate (RR) of treatment were calculated.Results: When cantharidin combined with chemotherapy, 4 clinicalstudies which included 155 patients with advanced colorectal cancer were considered eligible for inclusion.The systematic analysis suggested that, in all patients, pooled RR was 46.5% (72/155) in cantharidin combinedregimens. Major adverse effects were neutropenia, leukopenia, fatigue, and anemia with cantharidin combinedtreatment; no treatment related deaths occurred. Conclusion: This systematic analysis suggests that cantharidincombined regimens are associated with high response rate and accepted toxicity in treating Chinese patientswith metastatic colorectal cancer suggesting that randomized clinical trials are now warranted.http://journal.waocp.org/article_30368_209f663526fe8eaece2c4fe91dac7659.pdfCantharidincolorectal cancerchemotherapy combinationresponse ratetoxicityengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109811098430370Prevalence of Esophageal Cancer in the Northern Part of AfghanistanBackground: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patientspresenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancerin the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophagealcancer among patients in this region. Materials and Methods: We identified 364 consecutive patients that receivedEGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospitalfrom March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years ormore. We evaluated the results retrospectively. Results: The cases consisted of 184 (51%) males and 180 (49%)females. The mean age was 47.3±17.8 and the age range 17-88 years. Ninety two cases had esophageal cancer, outof which 58 (63.0%) were male. The mean age at time of diagnosis was 57.8±13.2 years. Uzbek-Turkmen peopleswere more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptomamong patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. Conclusions:Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in theUzbek-Turkmen ethnic group.http://journal.waocp.org/article_30370_0086d06c510da72bcbd747489e9fcc9c.pdfesophagus cancerEndoscopynorthern part of AfghanistanEthnicityengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109851098930371DNA Ligase4 as a Prognostic Marker in Nasopharyngeal Cancer Patients Treated with RadiotherapyBackground: The capability for DNA double-strand breaks (DSBs) repair is crucial for inherent radiosensitivityof tumor and normal cells. We have investigated the clinicopathologic significance of DNA repair gene expressionin nasopharyngeal (NP) carcinoma. Materials and Methods: A total of 65 NP cancer patients who receivedradiotherapy were included. The immunopositivity to Ku 70, DNA-PKcs, MRN, RAD50, XRCC4, and LIG4were examined in all tumor tissues. Results: The patients comprised 42 males and 23 females, with a median ageof 56 years (range, 18-84). The expression levels of RAD50 (0,+1,+2,+3) were 27.7%, 32.3%, 21.5%, and 18.5%.LIG4 (±) were 43.1% and 56.9% respectively. The 5-year OS rate of patients with LIG4 (±) were 90% and67.9%, respectively (p=0.035). The 5-year TTP rate of patients with LIG4 (±) were 75.9%, 55.5%, respectively(P=0.039). Conclusions: Our results suggest the possibility of predicting the radiosensitivity of NP cancer byperforming immunohistochemical analysis of LIG4.http://journal.waocp.org/article_30371_f200a4657282c6704a1a70ca5d305e14.pdfNasopharyngeal carcinomaradiotherapynonhomologous end joiningDNA repair genesLIG4engAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109911099230373Pan Masala Plus Tobacco is Equal to Gutka Square - New Formulation of Tobacco in India after the Gutka BanTobacco is a well known cause of death worldwide. With existing comprehensive laws and various othermeasures for tobacco control, the mortality and morbidity due to tobacco usage have unfortunately not beenreduced. A large number of tobacco users have altered their pattern of tobacco use after the gutka ban. Traditionalgutka is sold in the open market in a pre-mixed format. Manufacturers are supplying pan masala and tobaccoin separate pouches as there is no restriction for sale of pan masala and tobacco individually in many states.Although most of the population is aware of the health hazards of tobacco, it is necessary to develop an effectivestructured strategy. Tobacco control programs need to be strengthened by separate tobacco control measuresat various levels.http://journal.waocp.org/article_30373_09860faf0cb8e02ca97a33caa0fd6417.pdftobacco controlgutkapan masalaseparate saleengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109931099330375Substance P is a Major Mediator Causing Delayed Emesis in Anthracycline-Based Chemotherapy - Really?http://journal.waocp.org/article_30375_fde74c3c37adc30bef45f10b8c1197e3.pdfengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109951099530377Survival Outcome of AML Patients with and without TKD Mutationshttp://journal.waocp.org/article_30377_f7e7dac7330ab9d817bcbc784bb7e4de.pdfengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109971099830378Expectations of Response from Octreotide Therapy in Recurrent Phosphaturic Mesenchymal Tumors - Do They Reflect Reality?http://journal.waocp.org/article_30378_f078e3da47c56656da1f3649b6c3d871.pdfengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524109991099930380Thyroid Autoantibodies and Breast Cancerhttp://journal.waocp.org/article_30380_091635078b99f08d75c5fb4688e8a8df.pdfengAsian Pacific Organization for Cancer PreventionAsian Pacific Journal of Cancer Prevention1513-73682476-762X2014-12-011524110011100130381Gestational Diabetes Mellitus and Subsequent Cancer Risk: Shared Risk Factors, Causality or Confounding?http://journal.waocp.org/article_30381_1a6d71e4a461835867cdbdcd1cbc05bb.pdf